Provider Demographics
NPI:1326495458
Name:MOREJON, ANDREW (LAC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MOREJON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:MOREJON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:163 COLIGNI AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-2414
Mailing Address - Country:US
Mailing Address - Phone:914-755-1806
Mailing Address - Fax:
Practice Address - Street 1:1 WESTCHESTER PARK DR
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-3426
Practice Address - Country:US
Practice Address - Phone:914-755-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0291161174400000X
NY006775171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist