MEDICARE: DR. MARIA VICTORIA MORENO CUTTLE MD

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	207Q00000X	Family Medicine Physician	2011-01940	NC
2	207QA0505X	Adult Medicine Physician	265367	NY
3	207Q00000X	Family Medicine Physician	265367	NY

General Provider Information

NPI Number	:	1801052253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA VICTORIA MORENO CUTTLE MD

Provider Business Mailing Address
First Line	:	372 DEKALB AVE APT 3E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3832
Country	:	US
Telephone Number	:	917-757-7446
Fax Number	:	516-719-0708

Provider Business Practice Location Address
First Line	:	8010 NORTHERN BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1345
Country	:	US
Telephone Number	:	718-429-2800
Fax Number	:

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

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	02/19/2019

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