Healthcare Provider Details

I. General information

NPI: 1871481036
Provider Name (Legal Business Name): ISABELLA R MORA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 WASHINGTON ST STE 301
POUGHKEEPSIE NY
12601-2316
US

IV. Provider business mailing address

80 WASHINGTON ST STE 301
POUGHKEEPSIE NY
12601-2316
US

V. Phone/Fax

Practice location:
  • Phone: 845-522-2777
  • Fax:
Mailing address:
  • Phone: 845-522-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013959
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: