Provider Demographics
NPI:1649395187
Name:MORGAN, PETER H (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:H
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 ADELPHI AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-3414
Mailing Address - Country:US
Mailing Address - Phone:914-424-6773
Mailing Address - Fax:
Practice Address - Street 1:651 W 180TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4802
Practice Address - Country:US
Practice Address - Phone:212-781-8858
Practice Address - Fax:212-781-8859
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004569-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX27811Medicare PIN