Provider Demographics
NPI:1942022322
Name:MORRIS, KYUN T
Entity type:Individual
Prefix:
First Name:KYUN
Middle Name:T
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 SOUTH 11TH STREET
Mailing Address - Street 2:HOME
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108
Mailing Address - Country:US
Mailing Address - Phone:973-489-0726
Mailing Address - Fax:
Practice Address - Street 1:811 SOUTH 11TH STREET
Practice Address - Street 2:HOME
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108
Practice Address - Country:US
Practice Address - Phone:973-489-0726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide