Provider Demographics
NPI:1548212236
Name:MORABITO, ANDREW F (BC-HIS)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:F
Last Name:MORABITO
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LONG POND RD
Mailing Address - Street 2:SUITE 251
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1177
Mailing Address - Country:US
Mailing Address - Phone:585-225-1100
Mailing Address - Fax:585-225-1112
Practice Address - Street 1:1100 LONG POND RD
Practice Address - Street 2:SUITE 251
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1177
Practice Address - Country:US
Practice Address - Phone:585-225-1100
Practice Address - Fax:585-225-1112
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000016559174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0007768711OtherAETNA
NYP3670472OtherOXFORDHEALTH
NYDD7629OtherRAILROAD MEDICARE GRP #
NY116464A1OtherPREFERRED CARE
NY7102000NY14626OtherBC/BS OF MICHIGAN
NYBA0221Medicare ID - Type UnspecifiedGROUP #