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1801650742
YANS COSCULLUELA MORENO
FAR ROCKAWAY, NY
NPI
1801650742
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-02-12
Last Update Date
2024-02-12
Business Address
YANS COSCULLUELA MORENO MD
327 BEACH 19TH ST
FAR ROCKAWAY, NY 11691-4423
Phone number: 718-869-7672
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Mailing Address
YANS COSCULLUELA MORENO MD
151 LECHASE DR APT C
ROCHESTER, NY 14606-5139
Phone number: 407-545-9011
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