Individual
PATRICK J MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 PETERS RD STE 200-201, LITITZ, PA 17543-7685
(717) 626-2167
(717) 626-1915
Mailing address
51 PETERS RD STE 200-201, LITITZ, PA 17543-7685
(717) 626-2167
(717) 626-1915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD445070
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD445070
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102803447
—
PA
Enumeration date
05/21/2009
Last updated
03/23/2023
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