| Doctor Name: | MELISSA W MORENO |
| NPI Number: | 1528082187 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | F344757-1 |
| Business Practice Address: | 25 Hemlock Dr Congers, NY - 109201401 |
| Business Phone Number: | 8452670110 |
| Business Fax Number: | 8452672634 |
| Mailing Address: | 80 Sunset Rd, BLAUVELT |
| State: | NY |
| Postal Code: | 109131332 |
| Phone Number: | 9142626216 |
| Fax Number: | |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 02/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F344757-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |