Basic Information
Provider Information
NPI: 1477226835
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURAWSKI
FirstName: MORGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 KINGS HWY S
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146175504
CountryCode: US
TelephoneNumber: 5853684020
FaxNumber: 5853684009
Practice Location
Address1: 1555 LONG POND RD
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146264122
CountryCode: US
TelephoneNumber: 5853684020
FaxNumber: 5853684009
Other Information
ProviderEnumerationDate: 07/30/2021
LastUpdateDate: 11/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X383236NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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