Provider Demographics
NPI:1336700996
Name:MORALES, SENDY
Entity Type:Individual
Prefix:
First Name:SENDY
Middle Name:
Last Name:MORALES
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 1:697 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6946
Mailing Address - Country:US
Mailing Address - Phone:508-399-7700
Mailing Address - Fax:508-399-7703
Practice Address - Street 1:697 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-6946
Practice Address - Country:US
Practice Address - Phone:508-399-7700
Practice Address - Fax:508-399-7703
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA83-3735396Medicaid