Individual
DR. MORGAN L PRUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(646) 426-3876
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L-263332
MA
2084A2900X
Neurocritical Care Physician
67374
CT
2084N0400X
Neurology Physician
298746
NY
2084N0400X
Neurology Physician
Primary
67374
CT
Other
Enumeration date
06/09/2015
Last updated
06/10/2021
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