Provider Demographics
NPI:1750337382
Name:MORONE, TERESA MONICA (DO)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:MONICA
Last Name:MORONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:GIBLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:627 CROSS KEYS RD # B
Mailing Address - Street 2:DBA: CROSS KEYS URGENT CARE
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-9562
Mailing Address - Country:US
Mailing Address - Phone:856-728-8700
Mailing Address - Fax:856-318-1374
Practice Address - Street 1:627 CROSS KEYS RD # B
Practice Address - Street 2:DBA: CROSS KEYS URGENT CARE
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-9562
Practice Address - Country:US
Practice Address - Phone:856-728-8700
Practice Address - Fax:856-318-1374
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03780500207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061497000OtherAMERIHEALTH
NJ2173409Medicaid
NJ223586506005OtherCHAMPUS/TRICARE
NJ057757Medicare ID - Type Unspecified
NJ223586506005OtherCHAMPUS/TRICARE