MEDICARE: DR. MARK V. MORANO D.P.M.

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	213ES0131X	Foot Surgery Podiatrist	006272	NY
2	213ES0131X	Foot Surgery Podiatrist	N006272-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811154339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK V. MORANO D.P.M.

Provider Business Mailing Address
First Line	:	1505B MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2617
Country	:	US
Telephone Number	:	718-758-5043
Fax Number	:	718-758-5044

Provider Business Practice Location Address
First Line	:	1505B MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2617
Country	:	US
Telephone Number	:	718-758-5043
Fax Number	:	718-758-5044

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	12/05/2019

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Directions to “ DR. MARK V. MORANO D.P.M.” Practice Location

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