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NPI Code Detail

MEDICARE: MS. MARYNEZ EQUIHUA MORALES RN

MEDICARE: MS. MARYNEZ EQUIHUA MORALES RN
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
1164X00000XLicensed Vocational NurseVN 236012CA
2163W00000XRegistered Nurse698786NY

General Provider Information

NPI Number : 1164736989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARYNEZ EQUIHUA MORALES RN
Provider Business Mailing Address
First Line : 2262 GRAND AVE
Second Line :
City : BRONX
State : NY
Zip : 10453-1545
Country : US
Telephone Number : 619-518-9536
Fax Number :
Provider Business Practice Location Address
First Line : 2262 GRAND AVE
Second Line :
City : BRONX
State : NY
Zip : 10453-1545
Country : US
Telephone Number : 619-518-9536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2010
Last Update Date : 06/19/2015

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