Provider Demographics
NPI:1922015304
Name:SHOROFSKY, MORRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:
Last Name:SHOROFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8509
Mailing Address - Country:US
Mailing Address - Phone:212-751-0777
Mailing Address - Fax:212-308-5228
Practice Address - Street 1:166 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8509
Practice Address - Country:US
Practice Address - Phone:212-751-0777
Practice Address - Fax:212-308-5228
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY27268Medicare ID - Type Unspecified
NYB12048Medicare UPIN