Provider Demographics
NPI:1891778577
Name:MORRIS CHARYTAN MD PC
Entity Type:Organization
Organization Name:MORRIS CHARYTAN MD PC
Other - Org Name:COMMUNITY PEDIATRIC AND FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARYTAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-825-5599
Mailing Address - Street 1:20 ADDISON PL
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5914
Mailing Address - Country:US
Mailing Address - Phone:516-825-5599
Mailing Address - Fax:516-825-8317
Practice Address - Street 1:20 ADDISON PL
Practice Address - Street 2:V
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5914
Practice Address - Country:US
Practice Address - Phone:516-825-5599
Practice Address - Fax:516-825-8317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWET711Medicare UPIN
NY37D481Medicare ID - Type Unspecified
B13924Medicare UPIN