Individual
CICELY MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4 LONGMEADOW VILLAGE DR, NILES, MI 49120-7809
(269) 684-6000
Mailing address
4 LONGMEADOW VILLAGE DR, NILES, MI 49120-7809
(269) 684-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01083223A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
4301509637
MI
Other
Enumeration date
01/20/2017
Last updated
01/16/2026
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