Provider Demographics
NPI:1871806620
Name:MORALES, JEANINE ANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEANINE
Middle Name:ANNA
Last Name:MORALES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4118
Mailing Address - Country:US
Mailing Address - Phone:516-319-7460
Mailing Address - Fax:
Practice Address - Street 1:44 GORDON AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4118
Practice Address - Country:US
Practice Address - Phone:516-319-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool