Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Roberto Antonio Moran, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1528550647

Roberto Antonio Moran, MD is a Student in an Organized Health Care Education/Training Program in Corona, New York. Practices as a sole proprietor. Licensed in Illinois and New York.

Licensed in
IL, NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10211 Roosevelt Ave Ste 4
Corona, NY 11368-2331
Phone: (718) 898-1386
Fax: (718) 898-1093
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 313493 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 125072763 (IL)

Record details

NPI number1528550647
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 4, 2018
Last updated in NPPESApril 27, 2022
Certification dateApril 27, 2022
Mailing address10211 Roosevelt Ave Ste 4, Corona, NY 11368-2331

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