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NPI Code Detail

MEDICARE: EDGAR MORAN

MEDICARE: EDGAR MORAN
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1518775576
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR MORAN
Provider Business Mailing Address
First Line : 1623 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 718-377-5755
Fax Number :
Provider Business Practice Location Address
First Line : 1623 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 718-377-5755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2024
Last Update Date : 12/19/2025

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Directions to “ EDGAR MORAN ” Practice Location

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