Individual
TIANA SUNSHINE MORANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1231 DEER PARK AVE, NORTH BABYLON, NY 11703-3104
(631) 667-0338
Mailing address
2197 LOUIS KOSSUTH AVE, RONKONKOMA, NY 11779-6320
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
626459
NY
363L00000X
Nurse Practitioner
Primary
348165
NY
363L00000X
Nurse Practitioner
626459
NY
Other
Enumeration date
05/24/2021
Last updated
12/27/2021
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