Individual
EGLA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MUR PL, BRENTWOOD, NY 11717-2935
(631) 408-5150
Mailing address
133 S HICKORY ST, PORT JEFFERSON STATION, NY 11776-3153
(631) 408-5150
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
937802
NY
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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