Provider Demographics
NPI:1760484091
Name:MORRA, JOSEPH GERARD (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GERARD
Last Name:MORRA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2988 NABIL ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9504
Mailing Address - Country:US
Mailing Address - Phone:315-450-8686
Mailing Address - Fax:
Practice Address - Street 1:5349 W TAFT RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2747
Practice Address - Country:US
Practice Address - Phone:315-458-8010
Practice Address - Fax:315-458-8011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50811BMedicare ID - Type UnspecifiedMEDICAR
NYT26733Medicare UPIN