Provider Demographics
NPI:1225026271
Name:MORIARTY, NANCY (PT,DPT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2310 BALE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1795
Mailing Address - Country:US
Mailing Address - Phone:919-364-4000
Mailing Address - Fax:919-746-9229
Practice Address - Street 1:2310 BALE ST STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1795
Practice Address - Country:US
Practice Address - Phone:919-364-4000
Practice Address - Fax:919-746-9229
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17483225100000X
NY01673912251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
814493OtherEMPIRE MPN
10038514OtherCDPHP
2344476OtherAETNA HMO
7601093OtherAETNA PPO
814493OtherEMPIRE MPN