Provider Demographics
NPI:1609599588
Name:MORALES, PEDRO LUIS JR
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:LUIS
Last Name:MORALES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-1612
Mailing Address - Country:US
Mailing Address - Phone:724-406-9166
Mailing Address - Fax:
Practice Address - Street 1:410 CAMERON DR
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1612
Practice Address - Country:US
Practice Address - Phone:724-406-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program