Provider Demographics
NPI:1417212317
Name:MORENO, ESTHER (TEACHER)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 LEVINSOHN PL
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2120
Mailing Address - Country:US
Mailing Address - Phone:917-804-0257
Mailing Address - Fax:
Practice Address - Street 1:348 E 146TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5702
Practice Address - Country:US
Practice Address - Phone:718-585-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist