Basic Information
Provider Information
NPI: 1841855251
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOWDEN
FirstName: MORGAN
MiddleName: FLEZZANI
NamePrefix:  
NameSuffix:  
Credential: AGACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 416457
Address2:  
City: BOSTON
State: MA
PostalCode: 022416457
CountryCode: US
TelephoneNumber: 8443621735
FaxNumber: 9732907495
Practice Location
Address1: 100 MADISON AVE
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739717001
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2019
LastUpdateDate: 11/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X26NJ01146500NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LA2100X431353NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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