Provider Demographics
NPI:1164949384
Name:MORAN, HILDA PATRICIA
Entity Type:Individual
Prefix:MISS
First Name:HILDA
Middle Name:PATRICIA
Last Name:MORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6686 80TH ST FL 2ND
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2726
Mailing Address - Country:US
Mailing Address - Phone:347-863-2384
Mailing Address - Fax:
Practice Address - Street 1:6686 80TH ST FL 2ND
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2726
Practice Address - Country:US
Practice Address - Phone:347-863-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSF16617VMedicaid