GLENDA MORENO


Address: 101 Nicholls Rd, Stony Brook, NY 11794-0001
Phone: 6316898333

GLENDA MORENO (NPI# 1396767315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396767315
Entity Type Individual
Full Name GLENDA MORENO
Credential APN, PNP
Practice Address 101 Nicholls Rd
Stony Brook
NY 11794-0001
Mailing Address 1000 N Village Ave
Rockville Centre
NY 11570-1000
Practice Telephone 6316898333
Mailing Telephone 5167051353
Enumeration Date 2006-07-25
Last Update Date 2018-10-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health 		F301531-1 NY Physician Assistants & Advanced Practice Nursing Providers
N 363LP0200X Nurse Practitioner
Specialization: Pediatrics 		F381010-1 NY Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1000 N. Village Avenue, Rockville Centre, NY 11571 5167051353
201 Manor Pl, Greenport, NY 119441298 6314775144

Office Location

Street Address 101 NICHOLLS RD
City STONY BROOK
State NY
Zip Code 11794-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558981233 Matthew Dicicco Registered Nurse 101 Nicholls Rd, Stony Brook, NY 11794-0001 2020-04-22
1457970832 Dorian Cohen Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Stony Brook, NY 11794-0001 2020-04-15
1326508557 Brooke Noelle Learned Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Stony Brook, NY 11794-0001 2019-03-22
1578060414 Albert Xiao Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Stony Brook, NY 11794-0001 2018-04-08
1649704941 Caitlin Moran Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Stony Brook, NY 11794-0001 2017-04-13
1306379524 Kelsi Hirai Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Hsc 19-030, Stony Brook, NY 11794-0001 2017-04-05
1811381098 Monica Lee Pediatrics 101 Nicholls Rd, Stony Brook, NY 11794 2015-03-25
1275946147 Brenda J Sheehan Nurse Practitioner 101 Nicholls Rd, Sbuh, Palliative Care Service- Hsc Level T-15, Rm.053, Stony Brook, NY 11794-0001 2014-06-08
1225398142 Maria Del Mar Capo Martinez Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Stony Brook University Medical Center Level2-766, Stony Brook, NY 11794-7025 2012-05-24
1992065569 Dhanalakshmi Balakrishnan Student in an Organized Health Care Education/Training Program 101 Nicholls Rd, Department of Pathology, Level 2-766, Stony Brook, NY 11794-0001 2012-05-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619506714 Ryan John Kottmeier Physician Assistant 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 2020-04-02
1699302109 Michael Trentalange Student in an Organized Health Care Education/Training Program Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 2020-03-25
1164985156 Lauren Kate Harris Student in an Organized Health Care Education/Training Program Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 2019-04-08
1851851448 Kathy Tin Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 2019-03-21
1174083703 Arham Khan Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 2019-03-20
1396221982 Aman Bhojani Student in an Organized Health Care Education/Training Program Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 2018-07-17
1699265629 Belliny Phaeton Student in an Organized Health Care Education/Training Program Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-15
1629568969 Rachel Herold Student in an Organized Health Care Education/Training Program Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-11
1598254419 Nora Ann Diraimondo Nurse Practitioner Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 2018-05-07
1386140705 Ryan Christopher Corn Student in an Organized Health Care Education/Training Program Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 2018-04-04
Find all providers in zip 11794

Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033764006 Jeanine Michelle Carnival Nurse Practitioner 101 Nicholls Road Stony Brook Hospita, Stony Brook, NY 11794-0001 2019-08-07
1285104588 Jacob Parathodathil Joseph Nurse Practitioner Stony Brook Medical Center Health Science Center T 16, Stony Brook, NY 11794-0001 2018-11-29
1598254419 Nora Ann Diraimondo Nurse Practitioner Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 2018-05-07
1467960294 Christian Routh Nurse Practitioner Vascular Surgery Hsc T19-090, Stony Brook, NY 11794-8191 2018-01-15
1972021582 Louren M Gonzales Nurse Practitioner 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 2017-09-04
1144745258 Danielle J Kelly Nurse Practitioner Stony Brook Medicine 101 Nicolls Road, Stony Brook, NY 11794-0001 2017-08-09
1205289592 Stefani Lynn Pagliuca Nurse Practitioner Department of Medicine Hsc T16, Rm020, Stony Brook, NY 11794-8403 2016-07-21
1477975845 Michele L Degraw Nurse Practitioner Hsc T15-040, Stony Brook, NY 11794-4413 2014-01-20
1245503804 Antonieta Ababa Rosenberg Nurse Practitioner 13n Neurology Department Rm 023, Stony Brook University Hospital, 101 Nichols Rd, Stony Brook, NY 11794-0001 2012-02-13
1649555889 Kerin Culver Beedenbender Nurse Practitioner 19-20 Health Sciences Ctr, Stony Brook, NY 11794-0001 2011-10-19
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Competitor

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City STONY BROOK
Zip Code 11794

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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