Provider Demographics
NPI:1801052253
Name:MORENO CUTTLE, MARIA VICTORIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VICTORIA
Last Name:MORENO CUTTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:372 DEKALB AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3832
Mailing Address - Country:US
Mailing Address - Phone:917-757-7446
Mailing Address - Fax:516-719-0708
Practice Address - Street 1:8010 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1345
Practice Address - Country:US
Practice Address - Phone:718-429-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01940207Q00000X
NY265367207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine