Provider Demographics
NPI:1710382742
Name:MORCOS, BERNADETTE A (BS)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:A
Last Name:MORCOS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4610
Mailing Address - Country:US
Mailing Address - Phone:646-715-4563
Mailing Address - Fax:
Practice Address - Street 1:8510 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4610
Practice Address - Country:US
Practice Address - Phone:718-680-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist