MEDICARE: ROBERT A MORAGHAN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	557409	NY
2	367500000X	Certified Registered Nurse Anesthetist	557409	NY

General Provider Information

NPI Number	:	1023286408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A MORAGHAN CRNA

Provider Business Mailing Address
First Line	:	55 CORBIN PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4801
Country	:	US
Telephone Number	:	646-306-3996
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 CORBIN PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4801
Country	:	US
Telephone Number	:	646-306-3996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	08/04/2023

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