Individual
MRS. MARIA I MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4956
CT
2251G0304X
Geriatric Physical Therapist
4956
CT
2251H1200X
Hand Physical Therapist
4956
CT
2251P0200X
Pediatric Physical Therapist
4956
CT
2251S0007X
Sports Physical Therapist
4956
CT
2251X0800X
Orthopedic Physical Therapist
4956
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004175114
—
CT
01
—
080004956CT03
ANTHEM BCBS
CT
01
—
114175114-00
BLUE CARE FAMILY PLAN
CT
01
—
3372505
AETNA
CT
01
—
64-04254
UNITED HEALTHCARE
CT
01
—
712712
CONNECTICARE
CT
01
—
A667399
OXFORD
CT
01
—
OV1691
HEALTHNET
CT
Enumeration date
02/19/2007
Last updated
05/06/2019
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