=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750227633
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALESSANDRA MOURA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2026
-----------------------------------------------------
Last Update Date | 04/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1592 KINGS HWY N STE 21
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08034-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-273-4344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7531 ZIMMERMAN AVE
-----------------------------------------------------
City | PENNSAUKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08110-3836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-601-3683
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WA2000X
-----------------------------------------------------
Taxonomy Name | Administrator Registered Nurse
-----------------------------------------------------
License Number | 26NR27682800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------