Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 181210 | NY |
NPI | 1245272491 |
---|---|
Provider Name | Dr. Peter Joseph Morelli |
First Address | Stony Brook, NY 11790-0989 |
Second Address | Stony Brook, NY 11794-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 03/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01753731 | (05) | NY |
542541 | EMPIRE BC.BS (01) | NY |
5999580 | AETNA (01) | NY |
G49924 | (02) | NY |