Provider Demographics
NPI:1245310069
Name:MORGAN, BRETT (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12845 BROADWAY ST
Mailing Address - Street 2:STE 2
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-1223
Mailing Address - Country:US
Mailing Address - Phone:716-902-5068
Mailing Address - Fax:716-902-4050
Practice Address - Street 1:12845 BROADWAY ST STE 2
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-1223
Practice Address - Country:US
Practice Address - Phone:716-902-5068
Practice Address - Fax:716-902-4050
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020457-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist