Individual
LISA B. MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
135 E 83RD ST, NEW YORK, NY 10028-2408
(212) 686-6321
Mailing address
12 E 86TH ST APT 1530, NEW YORK, NY 10028-0516
(718) 350-6680
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
223927
NY
207K00000X
Allergy & Immunology Physician
MD044781
DC
208000000X
Pediatrics Physician
223927
NY
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
223927
NY
Other
Enumeration date
08/31/2006
Last updated
10/19/2022
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