Healthcare Provider Details

I. General information

NPI: 1598593550
Provider Name (Legal Business Name): MS. CLAUDIA MORANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N VILLAGE AVE STE 5
ROCKVILLE CENTRE NY
11570-3701
US

IV. Provider business mailing address

20117 53RD AVE
OAKLAND GARDENS NY
11364-1009
US

V. Phone/Fax

Practice location:
  • Phone: 516-766-0393
  • Fax:
Mailing address:
  • Phone: 718-749-7608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number031470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: