Individual
BASILISO MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
9131 QUEENS BLVD STE 618, ELMHURST, NY 11373-5543
(718) 275-0983
Mailing address
39 CAMBRIDGE TER APT B, HACKENSACK, NJ 07601-7202
(201) 467-9524
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/15/2012
Last updated
09/15/2012
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