Healthcare Provider Details

I. General information

NPI: 1982170486
Provider Name (Legal Business Name): LIVIU MOROGAN MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K5 CALLE 1 URB LA MILAGROSA
BAYAMON PR
00959-0095
US

IV. Provider business mailing address

K5 CALLE 1 URB LA MILAGROSA
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-235-6947
  • Fax:
Mailing address:
  • Phone: 787-235-6947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: