Provider Demographics
NPI:1952671778
Name:MORALES, CARMEN (RN)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 MAIN AVE
Mailing Address - Street 2:# 189
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-6167
Mailing Address - Country:US
Mailing Address - Phone:203-722-6773
Mailing Address - Fax:
Practice Address - Street 1:304 MAIN AVE
Practice Address - Street 2:# 189
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-6167
Practice Address - Country:US
Practice Address - Phone:203-722-6773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302003164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse