Provider Demographics
NPI:1225742844
Name:MORALES, LAISHA ABIGAIL (LPN)
Entity Type:Individual
Prefix:
First Name:LAISHA
Middle Name:ABIGAIL
Last Name:MORALES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 SAINT MARYS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1714
Mailing Address - Country:US
Mailing Address - Phone:718-578-2354
Mailing Address - Fax:
Practice Address - Street 1:191 SAINT MARYS AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1714
Practice Address - Country:US
Practice Address - Phone:718-578-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant