Healthcare Provider Details

I. General information

NPI: 1821086109
Provider Name (Legal Business Name): DEBORAH MORONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

PO BOX 418283
BOSTON MA
02241-8283
US

V. Phone/Fax

Practice location:
  • Phone: 202-687-4500
  • Fax:
Mailing address:
  • Phone: 703-558-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48390
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN48390
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: