Basic Information
Provider Information
NPI: 1033557178
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISON
FirstName: ERIC
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 ELMWOOD AVE
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: (585) 275-4912
FaxNumber: 5852762144
Practice Location
Address1: 601 ELMWOOD AVE
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146422818
CountryCode: US
TelephoneNumber: 5852754912
FaxNumber: 5852762144
Other Information
ProviderEnumerationDate: 06/11/2013
LastUpdateDate: 08/02/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X289075NYY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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