Provider Demographics
NPI:1013053750
Name:MORRIS SUSSEX FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:MORRIS SUSSEX FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LUCATORTO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-663-8899
Mailing Address - Street 1:694 STATE ROUTE 15 S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2249
Mailing Address - Country:US
Mailing Address - Phone:973-663-8899
Mailing Address - Fax:973-663-9511
Practice Address - Street 1:694 STATE ROUTE 15 S
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2249
Practice Address - Country:US
Practice Address - Phone:973-663-8899
Practice Address - Fax:973-663-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB60950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7105002Medicaid
NJ2355303001OtherAMERIHEALTH HMO PRAC ID
NJ093739Medicare ID - Type Unspecified
NJG04948Medicare UPIN