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Individual

MARIA L. MORO-DE-CASILLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 PERKINS FARM DRIVE, SUITE 103, MYSTIC, CT 06355
(860) 870-6385
(860) 245-0000
Mailing address
100 PERKINS FARM DRIVE, SUITE 103, MYSTIC, CT 06355
(860) 886-1433
(860) 886-4644

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
44391
CT
2084N0400X
Neurology Physician
Primary
MD11991
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001443910
CT
Enumeration date
07/16/2006
Last updated
07/19/2022
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