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General NPI Number Information
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NPI Number | 1720420755
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Entity Type | Individual
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Provider Name | PATRICIA ANNE MORAN M.S., B.A.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 91 BEYER DR
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City | POUGHQUAG
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State | NY
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Zip | 12570-5604
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Country | US
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Telephone | 845-724-4467
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Fax |
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Provider Business Mailing Address
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Address Line | 91 BEYER DR
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City | POUGHQUAG
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State | NY
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Zip | 12570-5604
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Country | US
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Telephone | 845-724-4467
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 536867041
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 031932001
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License Number State | NY
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