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NPI Code Detail

MEDICARE: JEAN LUDIZACA-MORALES

MEDICARE: JEAN LUDIZACA-MORALES
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
1183500000XPharmacist071270NY

General Provider Information

NPI Number : 1881455483
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN LUDIZACA-MORALES
Provider Business Mailing Address
First Line : 5001 CHURCH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-3503
Country : US
Telephone Number : 347-557-0959
Fax Number :
Provider Business Practice Location Address
First Line : 5001 CHURCH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-3503
Country : US
Telephone Number : 347-557-0959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2024
Last Update Date : 06/23/2024

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Directions to “ JEAN LUDIZACA-MORALES ” Practice Location

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