Provider Demographics
NPI:1609552280
Name:FESHLER, MORGAN BRYANT
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:BRYANT
Last Name:FESHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PLEASANT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2311
Mailing Address - Country:US
Mailing Address - Phone:860-463-7497
Mailing Address - Fax:
Practice Address - Street 1:270 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1836
Practice Address - Country:US
Practice Address - Phone:860-358-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.011991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily