Provider Demographics
NPI:1467542308
Name:MORREALE, EDWARD JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:MORREALE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3107
Mailing Address - Country:US
Mailing Address - Phone:718-437-9343
Mailing Address - Fax:718-633-7352
Practice Address - Street 1:405 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3107
Practice Address - Country:US
Practice Address - Phone:718-437-9343
Practice Address - Fax:718-633-7352
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005019213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113489780000OtherTOUCHSTONE PARTNERS
NYN005019OtherHIP
NYP3649204OtherOXFORD
NY01475332Medicaid
NYME5019OtherATLANTIS
NY4C8651OtherHEALTHNET
NY5959026OtherCIGNA
NY6200536OtherGHI
NY0001701-02OtherAMERICHOICE
NY1077532OtherUNITED HEALTH CARE
NY165879OtherELDERPLAN
NY113489780000OtherTOUCHSTONE PARTNERS
NY165879OtherELDERPLAN