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Individual

MRS. DEBRA JEAN MORENO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
126 E WOODLAND DR, WADING RIVER, NY 11792-9604
(631) 929-6890
Mailing address
126 E WOODLAND DR, WADING RIVER, NY 11792-9604
(631) 929-6890

Taxonomy

Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
619055
NY
163WG0600X
Gerontology Registered Nurse
619055
NY
163WM0705X
Medical-Surgical Registered Nurse
Primary
619055
NY

Other

Enumeration date
01/04/2010
Last updated
01/04/2010
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