Provider Demographics
NPI:1740460054
Name:MORALES-MARCELO, CARLOS (MA)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:MORALES-MARCELO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 W TILGHMAN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4354
Mailing Address - Country:US
Mailing Address - Phone:484-221-9136
Mailing Address - Fax:484-221-9130
Practice Address - Street 1:NARANJITO SHOPPING VILLAGE BO CEDRO ARRIBA
Practice Address - Street 2:CAR152 KM 12.5
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0071
Practice Address - Country:US
Practice Address - Phone:939-274-9637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1089-PA208D00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice