Provider Demographics
NPI:1801872924
Name:MORASON, ROBERT TODD (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:TODD
Last Name:MORASON
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 1:612 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-422-2020
Mailing Address - Fax:315-422-7339
Practice Address - Street 1:612 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-422-2020
Practice Address - Fax:315-422-7339
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216992174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
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NY375A61OtherEMPIRE BC/BS
NY375A61OtherEMPIRE BC/BS
NY10046358OtherCDPHP