Healthcare Provider Details

I. General information

NPI: 1922214394
Provider Name (Legal Business Name): ANNA MORAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N 39TH ST 542 WRIGHT-SAUNDERS
PHILADELPHIA PA
19104-2640
US

IV. Provider business mailing address

51 N 39TH ST 542 WRIGHT-SAUNDERS
PHILADELPHIA PA
19104-2640
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-8548
  • Fax:
Mailing address:
  • Phone: 215-662-8548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberMD429935
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD429935
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: