Individual
EUGENE MORTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 W 79TH ST STE 1, NEW YORK, NY 10024-6449
(646) 760-6131
Mailing address
4350 KAI IKENA DR, KALAHEO, HI 96741-9580
(646) 760-6131
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
281692
NY
Other
Enumeration date
05/12/2014
Last updated
01/16/2022
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