Provider Demographics
NPI:1902631047
Name:MORALES VALVERDE, EVELYN (PA-C)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:MORALES VALVERDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-1778
Mailing Address - Country:US
Mailing Address - Phone:631-353-9110
Mailing Address - Fax:
Practice Address - Street 1:400 PANTIGO PL
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-5902
Practice Address - Country:US
Practice Address - Phone:631-726-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical