Individual
NIA MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NIA MORAN,SLP, IBCLC
Contact information
Practice address
4356 SMART ST, FLUSHING, NY 11355-2153
(718) 664-0223
Mailing address
4356 SMART ST, FLUSHING, NY 11355-2153
(718) 664-0223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
174N00000X
Lactation Consultant (Non-RN)
Primary
L-314594
NY
235Z00000X
Speech-Language Pathologist
025628
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025628
NYS SLP LICENSE
NY
05
—
04603054
—
NY
01
—
L-314594
IBLCE
NY
Enumeration date
07/14/2013
Last updated
12/19/2023
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