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General NPI Number Information
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NPI Number | 1528417763
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Entity Type | Individual
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Provider Name | JESSICA ANARUTH MORAN
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Gender | Female
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 60 CHARLES LINDBERGH BLVD
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City | UNIONDALE
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State | NY
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Zip | 11553-3653
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Country | US
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Telephone | 516-227-8646
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Fax | 516-227-8663
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Provider Business Mailing Address
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Address Line | 2302 WESTLEY RD
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City | WESTBURY
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State | NY
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Zip | 11590-6018
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Country | US
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Telephone | 516-865-2909
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NY
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