Provider Demographics
NPI:1639212327
Name:MORRISSEY, EILEEN PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:PATRICIA
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1902 WHITESTONE EXPY
Mailing Address - Street 2:403
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3099
Mailing Address - Country:US
Mailing Address - Phone:718-767-2862
Mailing Address - Fax:718-767-2863
Practice Address - Street 1:1902 WHITESTONE EXPY
Practice Address - Street 2:403
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3099
Practice Address - Country:US
Practice Address - Phone:718-767-2862
Practice Address - Fax:718-767-2863
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04146-7122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist