Pamela Moran

Individual provider Active NPI Licensed Practical Nurse · Garrison, NY

NPI 1104284264 · NPPES record last updated Feb 4, 2016

Key facts

NPI
1104284264
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
145047-1 (NY)
Practice address
18 Forsonville LN
Garrison, NY 10524-3845
Phone
(845) 424-4924
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
145047-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 145047-1 NY Yes

Addresses

Primary practice location

18 Forsonville LN
Garrison, NY 10524-3845

Mailing address

18 Forsonville LN
Garrison, NY 10524-3845
Phone (845) 424-4924

Other providers in Garrison, NY

All providers in Garrison, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.