Provider Demographics
NPI:1962760348
Name:MORALES JIMENEZ, MARIELA JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIELA
Middle Name:JOSE
Last Name:MORALES JIMENEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:80 SEYMOUR STREET
Mailing Address - Street 2:HARTFORD HOSPITAL MEDICINE DEPT
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-8000
Mailing Address - Country:US
Mailing Address - Phone:860-972-0200
Mailing Address - Fax:
Practice Address - Street 1:132 JEFFERSON STREET
Practice Address - Street 2:HARTFORD HOSPITAL MEDICINE DEPT
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2429
Practice Address - Country:US
Practice Address - Phone:860-972-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10044079207R00000X
WAMD60511574207R00000X
CT067074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine