Provider Demographics
NPI:1659432292
Name:MORSE, DIANA FRANCES (MD)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:FRANCES
Last Name:MORSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W 4TH ST
Mailing Address - Street 2:MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4002
Mailing Address - Country:US
Mailing Address - Phone:914-699-7200
Mailing Address - Fax:914-699-0837
Practice Address - Street 1:107 W 4TH ST
Practice Address - Street 2:MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-4002
Practice Address - Country:US
Practice Address - Phone:914-699-7200
Practice Address - Fax:914-699-0837
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160110-12085R0202X
NY1601102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02460240(201)Medicaid
NY02460240(201)Medicaid
NY77K781Medicare ID - Type Unspecified