Healthcare Provider Details

I. General information

NPI: 1710794904
Provider Name (Legal Business Name): MORAL MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 CARRIAGE HOUSE DR
JERICHO NY
11753-2802
US

IV. Provider business mailing address

287 CARRIAGE HOUSE DR
JERICHO NY
11753-2802
US

V. Phone/Fax

Practice location:
  • Phone: 973-200-3964
  • Fax:
Mailing address:
  • Phone: 973-200-3964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MUHAMMAD MORAL
Title or Position: CHIEF EXECUTIVE OPERATOR
Credential: MD
Phone: 973-200-3964