Provider Demographics
NPI:1902858434
Name:MORANO, PLACIDO A (MD)
Entity Type:Individual
Prefix:
First Name:PLACIDO
Middle Name:A
Last Name:MORANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 EUSTON RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1201
Mailing Address - Country:US
Mailing Address - Phone:718-743-9642
Mailing Address - Fax:718-246-8601
Practice Address - Street 1:263 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3689
Practice Address - Country:US
Practice Address - Phone:718-246-8600
Practice Address - Fax:718-246-8601
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175433207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01191726Medicaid
NY01191726Medicaid
NY33E351Medicare PIN