MEDICARE: DR. JOSE RAMON MORALES M.D.

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	101YM0800X	Mental Health Counselor
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1245670991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE RAMON MORALES M.D.

Provider Business Mailing Address
First Line	:	1900B RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5302
Country	:	US
Telephone Number	:	718-253-1366
Fax Number	:	718-253-5890

Provider Business Practice Location Address
First Line	:	1900B RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5302
Country	:	US
Telephone Number	:	718-253-1366
Fax Number	:	718-253-5890

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

Provider Enumeration Date	:	06/26/2013
Last Update Date	:	06/26/2013

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