NPIMap

Organization Active NPI

Susan I Moreno M.D. P.C.

  • Specialist
  • Thorofare, NJ
National Provider Identifier
1457551442
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA05706900 Issued in NJ
Legal business name
SUSAN I MORENO M.D. P.C.
Practice address
196 Grove Ave
Suite E
Thorofare, NJ 08086
Phone
(856) 845-2323
Fax
(856) 845-4888
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Susan I Moreno
Title
Doctor
Phone
(856) 845-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA05706900 NJ Primary

Addresses

Primary practice location

196 Grove Ave
Suite E
Thorofare, NJ 08086

Mailing address

196 Grove Ave
Suite E
Thorofare, NJ 08086
Phone (856) 845-2323

Other identifiers 10

IdentifierTypeStateIssuer
0509463000OtherKEYSTONE, AMERI, BC/BS
2162090OtherAETNA
905513OtherFIRST HEALTH
1697844001OtherCIGNA
G22323OtherAMERI HEALTH ADMIN.
0558269000OtherAMERIIHEALTH PERSONAL CHO
722323OtherPABS PC
722323OtherAMERIHEALTH PC
P2681709OtherOXFORD HEALTH PLANS
722323OtherHORIZON BC/BS NJ

National Provider Directory

National Provider Directory

Locations

196 Grove Ave
Ste E
West Deptford, NJ 08086
Phone (856) 845-2323

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1457551442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 GROVE AVE",
            "address_2": "SUITE E",
            "city": "THOROFARE",
            "state": "NJ",
            "postal_code": "08086",
            "telephone_number": "856-845-2323",
            "fax_number": "856-845-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 GROVE AVE",
            "address_2": "SUITE E",
            "city": "THOROFARE",
            "state": "NJ",
            "postal_code": "08086",
            "telephone_number": "856-845-2323",
            "fax_number": "856-845-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN I MORENO M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "856-845-2323",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA05706900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE, AMERI, BC/BS",
            "identifier": "0509463000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2162090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "905513",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1697844001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERI HEALTH  ADMIN.",
            "identifier": "G22323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIIHEALTH PERSONAL CHO",
            "identifier": "0558269000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PABS PC",
            "identifier": "722323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PC",
            "identifier": "722323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P2681709",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC/BS NJ",
            "identifier": "722323",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thorofare, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.