Provider Demographics
NPI:1750561494
Name:MORELLI, BRIAN NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:NICHOLAS
Last Name:MORELLI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:DEPARTMENT OF ORTHOPAEDICS, HSC T18-080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8181
Mailing Address - Country:US
Mailing Address - Phone:631-444-1467
Mailing Address - Fax:631-444-8894
Practice Address - Street 1:181 N BELLE MEAD RD
Practice Address - Street 2:SPINE & SCOLIOSIS CENTER
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3495
Practice Address - Country:US
Practice Address - Phone:631-444-2225
Practice Address - Fax:631-444-4775
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2009-10-26
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Provider Licenses
StateLicense IDTaxonomies
NY249425207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03110703Medicaid
NY03110703Medicaid