Provider Demographics
NPI:1588609473
Name:MORGAN STREET FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:MORGAN STREET FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-359-9997
Mailing Address - Street 1:90 MORGAN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5466
Mailing Address - Country:US
Mailing Address - Phone:203-359-9997
Mailing Address - Fax:203-359-9957
Practice Address - Street 1:90 MORGAN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5466
Practice Address - Country:US
Practice Address - Phone:203-359-9997
Practice Address - Fax:203-359-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty