MEDICARE: MRS. CHRISTINE M. MORAN M.A.

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	235Z00000X	Speech-Language Pathologist	013240-1	NY

General Provider Information

NPI Number	:	1619068400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE M. MORAN M.A.

Provider Business Mailing Address
First Line	:	700 GROVE ST
Second Line	:	APT. 11U
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-1266
Country	:	US
Telephone Number	:	646-331-1674
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 GROVE ST
Second Line	:	APT. 11U
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-1266
Country	:	US
Telephone Number	:	646-331-1674
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/05/2008

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Directions to “ MRS. CHRISTINE M. MORAN M.A.” Practice Location

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