Provider Demographics
NPI:1720058571
Name:MORRISSEY, THOMAS P (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:MORRISSEY
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 1:701 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2305
Mailing Address - Country:US
Mailing Address - Phone:561-955-4986
Mailing Address - Fax:561-955-2115
Practice Address - Street 1:701 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2305
Practice Address - Country:US
Practice Address - Phone:954-659-5559
Practice Address - Fax:954-659-5560
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224909207VX0201X
FLME120459207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02286157Medicaid
NY02286157Medicaid