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Individual

MARIA MORENO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4 E 88TH ST, JAN J. SHIM, MD, NEW YORK, NY 10128-0509
(212) 535-5020
Mailing address
2 CATHARINE ST, P.O. BOX 550, POUGHKEEPSIE, NY 12601-3100
(845) 790-2661
(845) 790-2675

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
163229-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00916885
NY
Enumeration date
09/09/2005
Last updated
10/18/2007
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