Provider Demographics
NPI:1326271099
Name:MORALES, JUAN J (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:J
Last Name:MORALES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 POST RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-3614
Mailing Address - Country:US
Mailing Address - Phone:203-655-6464
Mailing Address - Fax:203-655-2859
Practice Address - Street 1:455 POST RD STE 201
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3614
Practice Address - Country:US
Practice Address - Phone:203-655-6464
Practice Address - Fax:203-655-2859
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist