Doctor Name: | LORETTA MORACO |
NPI Number: | 1336510585 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 543464 |
Business Practice Address: | 17 Cook St Kings Park, NY - 117544500 |
Business Phone Number: | 6313654746 |
Business Fax Number: | |
Mailing Address: | 17 Cook St, KINGS PARK |
State: | NY |
Postal Code: | 117544500 |
Phone Number: | 6313654746 |
Fax Number: | |
NPI Enumeration Date: | 10/14/2015 |
NPI Last Update Date: | 10/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 543464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |