Provider Demographics
NPI:1770983504
Name:MOREJON, ANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MOREJON
Suffix:
Gender:F
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 1:269 RICH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 W 24TH ST
Practice Address - Street 2:7 FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1911
Practice Address - Country:US
Practice Address - Phone:212-997-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0380552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic