Healthcare Provider Details

I. General information

NPI: 1366687782
Provider Name (Legal Business Name): ARGENTINA MORETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 CENTRAL AVE
LYNN MA
01901-1220
US

IV. Provider business mailing address

269 UNION ST
LYNN MA
01901-1314
US

V. Phone/Fax

Practice location:
  • Phone: 781-477-7222
  • Fax: 781-596-3966
Mailing address:
  • Phone: 781-477-7222
  • Fax: 781-596-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: