Healthcare Provider Details

I. General information

NPI: 1366375461
Provider Name (Legal Business Name): ANA GABRIELA MORONTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 WEBBER AVE
SOUTH HEMPSTEAD NY
11550-8042
US

IV. Provider business mailing address

1181 WEBBER AVE
SOUTH HEMPSTEAD NY
11550-8042
US

V. Phone/Fax

Practice location:
  • Phone: 516-469-6544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: