Provider Demographics
NPI:1477226835
Name:TYMOCH, MORGAN (PNP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:TYMOCH
Suffix:
Gender:
Credentials:PNP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:MURAWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 ELMGROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-6236
Mailing Address - Country:US
Mailing Address - Phone:315-585-4264
Mailing Address - Fax:
Practice Address - Street 1:900 ELMGROVE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-6236
Practice Address - Country:US
Practice Address - Phone:585-426-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY383236363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06825630Medicaid