Provider Demographics
NPI:1669462255
Name:MORROW, IRA STEPHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:STEPHEN
Last Name:MORROW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1237
Mailing Address - Country:US
Mailing Address - Phone:914-476-4040
Mailing Address - Fax:914-476-1267
Practice Address - Street 1:900 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1237
Practice Address - Country:US
Practice Address - Phone:914-476-4040
Practice Address - Fax:914-476-1267
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0342571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00418144Medicaid