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General NPI Number Information
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NPI Number | 1023346236
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Entity Type | Individual
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Provider Name | SUSAN CECILIA MORENO RPA-C
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Gender | Female
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Dates
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Enumeration Date | 11/28/2009
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Last Update Date | 07/27/2025
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Provider Practice Location Address
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Address Line | 8600 OLD GEORGETOWN RD
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City | BETHESDA
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State | MD
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Zip | 20814-1422
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Country | US
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Telephone | 301-896-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 9910 FRANKLIN SQUARE DR # 2110
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City | BALTIMORE
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State | MD
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Zip | 21236-4902
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Country | US
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Telephone | 410-933-5412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110003201
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C06789
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA031908
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License Number State | DC
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