Basic Information
| Provider Information | |||||||||
| NPI: | 1053336255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | AYMAN | ||||||||
| MiddleName: | HABIB | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 TROY SCHENECTADY RD STE 203 | ||||||||
| Address2: | |||||||||
| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121102461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187823700 | ||||||||
| FaxNumber: | 5187823799 | ||||||||
| Practice Location | |||||||||
| Address1: | 2125 RIVER RD | ||||||||
| Address2: | STE 303 | ||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123091135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188312500 | ||||||||
| FaxNumber: | 5188312510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 01/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 240474 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207R00000X | 240474 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 061220000018 | 01 | NY | FIDELIS CARE | OTHER | 7788864 | 01 | NY | AETNA | OTHER | 844L21 | 01 | NY | EMPIRE BLUECROSS BLUESHILED | OTHER | 000411942001 | 01 | NY | BSNENY | OTHER | 2355S1 | 01 | NY | BLUE CROSS | OTHER | 02792496 | 05 | NY | MEDICAID | 10113735 | 01 | NY | CDPHP | OTHER | 160615000070 | 01 | NY | FIDELIS | OTHER | 4149459 | 01 | NY | MVP | OTHER | 11571812 | 01 | NY | CAQH | OTHER |