Provider Demographics
NPI:1639593031
Name:M.ISLAND MEDICAL PC
Entity Type:Organization
Organization Name:M.ISLAND MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-661-7003
Mailing Address - Street 1:50 E 42ND ST RM 407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5437
Mailing Address - Country:US
Mailing Address - Phone:212-661-7003
Mailing Address - Fax:212-661-7005
Practice Address - Street 1:50 E 42ND ST
Practice Address - Street 2:407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5405
Practice Address - Country:US
Practice Address - Phone:212-661-7003
Practice Address - Fax:212-661-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234466174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty