Individual
MELANIE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 TAMARACK AVE STE 101, SOUTH WINDSOR, CT 06074-5556
(860) 644-4442
Mailing address
10 WEDGEWOOD DR APT A6, BLOOMFIELD, CT 06002-1936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7548
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/10/2025
Last updated
02/09/2026
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