Provider Demographics
NPI:1740657881
Name:MORRIS, ROSALIND M I (LPN MT)
Entity type:Individual
Prefix:MS
First Name:ROSALIND
Middle Name:M
Last Name:MORRIS
Suffix:I
Gender:F
Credentials:LPN MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 HANCOCK ST
Mailing Address - Street 2:PH-3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2202
Mailing Address - Country:US
Mailing Address - Phone:347-260-6884
Mailing Address - Fax:347-924-9508
Practice Address - Street 1:257 HANCOCK ST
Practice Address - Street 2:PH-3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2202
Practice Address - Country:US
Practice Address - Phone:347-260-6884
Practice Address - Fax:347-924-9508
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212885172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker