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General NPI Number Information
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NPI Number | 1487100947
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Entity Type | Individual
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Provider Name | MONICA MORALES PT
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Gender | Male
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 11808 GRANT ST
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City | OMAHA
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State | NE
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Zip | 68164-3613
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Country | US
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Telephone | 877-230-3885
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Fax | 402-505-9753
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Provider Business Mailing Address
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Address Line | 41 JERUSALEM AVE
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City | LEVITTOWN
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State | NY
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Zip | 11756-3729
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 025174
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License Number State | PA
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