Provider Demographics
NPI:1992965784
Name:MORALES, ANA CORINA (RN CNOR CRNFA)
Entity type:Individual
Prefix:MISS
First Name:ANA
Middle Name:CORINA
Last Name:MORALES
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Gender:F
Credentials:RN CNOR CRNFA
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Mailing Address - Street 1:57 PARK PL
Mailing Address - Street 2:BLOOMFIELD
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3526
Mailing Address - Country:US
Mailing Address - Phone:973-744-6079
Mailing Address - Fax:973-744-6079
Practice Address - Street 1:57 PARK PL
Practice Address - Street 2:BLOOMFIELD
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3526
Practice Address - Country:US
Practice Address - Phone:973-744-6079
Practice Address - Fax:973-744-6079
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2016-12-09
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Provider Licenses
StateLicense IDTaxonomies
NJ26NO10460400363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1992965784Medicaid