MEDICARE: DR. JAMES R MORALES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	MA69005	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D076153	OTHER	NJ	CDS

General Provider Information

NPI Number	:	1386649507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES R MORALES MD

Provider Business Mailing Address
First Line	:	49 KENT RD
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-2452
Country	:	US
Telephone Number	:	732-901-2928
Fax Number	:	732-901-3980

Provider Business Practice Location Address
First Line	:	49 KENT RD
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-2452
Country	:	US
Telephone Number	:	732-901-2928
Fax Number	:	732-901-3980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	05/10/2021

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