Provider Demographics
NPI:1538484019
Name:MORGAN, BEVERLY ELOISE (RPH)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ELOISE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105-40 62ND RD APT 6B
Mailing Address - Street 2:FOREST HILLS
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-699-9658
Mailing Address - Fax:
Practice Address - Street 1:10540 62ND RD APT 6B
Practice Address - Street 2:FOREST HILLS
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1129
Practice Address - Country:US
Practice Address - Phone:718-699-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist