# MANUEL V MORENO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417153438
- **Authorized official:** LISA L WAGNER (OFFICE MANAGER)
- **Authorized official phone:** (570) 322-9948

## Contact information

- **Practice address:** 215 E WATER ST, MUNCY, PA 17756-8828
- **Practice address phone:** (570) 322-9948
- **Practice address fax:** (570) 322-6195
- **Mailing address:** PO BOX 56, MONTOURSVILLE, PA 17754-0056
- **Mailing address phone:** (570) 323-8091
- **Mailing address fax:** (570) 322-6195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | MD038231L | PA | Yes |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 05/19/2008