Basic Information
| Provider Information | |||||||||
| NPI: | 1740460054 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORALES-MARCELO | ||||||||
| FirstName: | CARLOS | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2030 W TILGHMAN ST | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181044354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4842219136 | ||||||||
| FaxNumber: | 4842219130 | ||||||||
| Practice Location | |||||||||
| Address1: | NARANJITO SHOPPING VILLAGE BO CEDRO ARRIBA | ||||||||
| Address2: | CAR152 KM 12.5 | ||||||||
| City: | NARANJITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007190071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9392749637 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2007 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 1089-PA | PR | N | Allopathic & Osteopathic Physicians | General Practice | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.