Individual
AIDA MINERVA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
480 AUDUBON AVE APT B4, NEW YORK, NY 10040-4368
(646) 836-0510
Mailing address
480 AUDUBON AVE APT B4, NEW YORK, NY 10040-4368
(646) 714-8453
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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