Healthcare Provider Details

I. General information

NPI: 1427970201
Provider Name (Legal Business Name): MICAELA NANCY MOSCOSO CUENCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 YOSEMITE DR
BEAR DE
19701-3806
US

IV. Provider business mailing address

7 YOSEMITE DR
BEAR DE
19701-3806
US

V. Phone/Fax

Practice location:
  • Phone: 302-743-0160
  • Fax:
Mailing address:
  • Phone: 302-743-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number230805210021
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: