Provider Demographics
NPI:1447313663
Name:MORENO MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:MORENO MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-222-9935
Mailing Address - Street 1:3053 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3605
Mailing Address - Country:US
Mailing Address - Phone:201-222-9935
Mailing Address - Fax:201-222-7935
Practice Address - Street 1:3053 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3605
Practice Address - Country:US
Practice Address - Phone:201-222-9935
Practice Address - Fax:201-222-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07035400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty