Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 062299 | NY |
NPI | 1194479386 |
---|---|
Provider Name | Dr. Hayleen E Moran |
First Address | Bronx, NY 10467-7714 |
Second Address | New York, NY 10007-1078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2022 |
Last Update Date | 07/02/2022 |