Basic Information
| Provider Information | |||||||||
| NPI: | 1114074119 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | NORMAN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 329 CONWAY ST | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 013011521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135867100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 329 CONWAY ST | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 013011526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137735119 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 01/30/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 146 | MA | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | AD0112 | 01 | MA | BCBS | OTHER | 697475 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 30920 | 01 | MA | HEALTH NEW ENGLAND | OTHER |