| J. G. Moreno, Md, Llc | |
|
205 Ridgedale Ave Florham Park NJ 07932-1349 | |
| (973) 966-0072 | |
| (908) 879-5009 |
| Full Name | J. G. Moreno, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 205 Ridgedale Ave, Florham Park, New Jersey |
| Authorized Official Name and Position | Jose G Moreno (OWNER) |
| Authorized Official Contact | 9739660072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. G. Moreno, Md, Llc 205 Ridgedale Ave Florham Park NJ 07932-1349 Ph: (973) 966-0072 | J. G. Moreno, Md, Llc 205 Ridgedale Ave Florham Park NJ 07932-1349 Ph: (973) 966-0072 |
| NPI Number | 1366771735 |
|---|---|
| Provider Enumeration Date | 12/15/2009 |
| Last Update Date | 12/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366771735 | NPI | - | NPPES |
| 461207 | Other | NJ | MEDICARE PTAN |
| 3449807 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA03554300 (New Jersey) | Primary |
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