Provider Demographics
NPI:1780019778
Name:MORAN, MARY B (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:B
Last Name:MORAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:CAPNA 51 WEST 51 STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-326-5708
Mailing Address - Fax:212-326-5700
Practice Address - Street 1:CAPNA 51 WEST 51ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-326-5708
Practice Address - Fax:212-326-5700
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY335514364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health