Provider Demographics
NPI:1740835495
Name:MORA, NAZARET AIDE
Entity type:Individual
Prefix:MS
First Name:NAZARET
Middle Name:AIDE
Last Name:MORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 E 181ST ST APT 8K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-1644
Mailing Address - Country:US
Mailing Address - Phone:347-458-9809
Mailing Address - Fax:
Practice Address - Street 1:1623 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1209
Practice Address - Country:US
Practice Address - Phone:718-954-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker