Basic Information
| Provider Information | |||||||||
| NPI: | 1942610589 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | MINA | ||||||||
| MiddleName: | ADEL | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 PATERSON ST # 3100 | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322356153 | ||||||||
| FaxNumber: | 7322355100 | ||||||||
| Practice Location | |||||||||
| Address1: | 1945 STATE ROUTE 33 | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327764483 | ||||||||
| FaxNumber: | 7327764798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2014 | ||||||||
| LastUpdateDate: | 09/07/2018 | ||||||||
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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 | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | 25MB10261100 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.