Individual
NICOLE MARIE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
NORTHERN BOULEVARD, P.O. BOX 8000, OLD WESTBURY, NY 11568
(516) 686-7687
Mailing address
237 MARTIN DR, SYOSSET, NY 11791-5407
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002411
NY
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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