Individual
CYNTHIA P MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1007 N POPE ST, HIDALGO MEDICAL SERVICES, SILVER CITY, NM 88061-5161
(575) 388-1511
(575) 542-2388
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-2388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CNP-01903
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22559558
—
NM
01
—
85-0292834
TAX ID
—
01
—
NMA102160
MEDICARE PTAN
—
Enumeration date
02/03/2012
Last updated
12/09/2014
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