Provider Demographics
NPI: | 1750169595 |
---|---|
Name: | MORPATH LLC |
Entity type: | Organization |
Organization Name: | MORPATH LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ORAL AND MAXILLOFACIAL PATHOLOGIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | DANNY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MORA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DMD, MS |
Authorized Official - Phone: | 919-523-7076 |
Mailing Address - Street 1: | 26 CALLE EL REY |
Mailing Address - Street 2: | |
Mailing Address - City: | ISABELA |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00662 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-523-7076 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 628 PEDRO VELAZQUEZ EDIFICIO AURORA 3B |
Practice Address - Street 2: | |
Practice Address - City: | PENUELAS |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00624 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-523-7076 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-09-21 |
Last Update Date: | 2023-09-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
No | 1223P0106X | Dental Providers | Dentist | Oral and Maxillofacial Pathology | Group - Multi-Specialty |
No | 1223S0112X | Dental Providers | Dentist | Oral and Maxillofacial Surgery | Group - Multi-Specialty |
No | 207ZC0500X | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | Group - Multi-Specialty |
No | 207ZI0100X | Allopathic & Osteopathic Physicians | Pathology | Immunopathology | Group - Multi-Specialty |
No | 207ZP0007X | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology | Group - Multi-Specialty |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
No | 207ZP0213X | Allopathic & Osteopathic Physicians | Pathology | Pediatric Pathology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 2086X0206X | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | Group - Multi-Specialty |
No | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | |
No | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental | |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | |
No | 261QS0112X | Ambulatory Health Care Facilities | Clinic/Center | Oral and Maxillofacial Surgery |