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Individual

MARIA MORENO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
8006 37TH AVE, JACKSON HEIGHTS, NY 11372-6720
(718) 424-5500
Mailing address
8006 37TH AVE, JACKSON HEIGHTS, NY 11372-6720
(718) 424-5500

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005712
NY
156FX1800X
Optician
8114-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02533448
NY
Enumeration date
05/16/2007
Last updated
09/11/2025
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