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General NPI Number Information
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NPI Number | 1063608990
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Entity Type | Organization
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Legal Business Name | JJ MOREIRA MD PC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 319 WILLIS AVE
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City | MINEOLA
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State | NY
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Zip | 11501
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Country | US
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Telephone | 917-273-4092
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Fax |
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Provider Business Mailing Address
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Address Line | 319 WILLIS AVE FL 2
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City | MINEOLA
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State | NY
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Zip | 11501-1510
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Country | US
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Telephone | 917-273-4092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH JOHN MOREIRA
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Credential | MD
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Telephone | 917-273-4092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 188071
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License Number State | NY
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