Individual
REBECCA MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 590-1800
Mailing address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(609) 675-0879
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008402
NY
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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