Individual
ENEIDA MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
900 INTERVALE AVE, BRONX, NY 10459-4240
(718) 732-7171
Mailing address
2114 HAVILAND AVE, APT 4D, BRONX, NY 10472-5295
(646) 807-7984
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144689829
—
NY
Enumeration date
02/23/2016
Last updated
03/10/2016
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