Provider Demographics
NPI:1952666901
Name:MOREIRA, ELEANOR (MSE)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:MOREIRA
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SNEDEN PL W
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3918
Mailing Address - Country:US
Mailing Address - Phone:845-459-7127
Mailing Address - Fax:845-290-1179
Practice Address - Street 1:111 SNEDEN PL W
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-3918
Practice Address - Country:US
Practice Address - Phone:845-459-7127
Practice Address - Fax:845-290-1179
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist