Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 022718 | NY |
NPI | 1053649772 |
---|---|
Provider Name | Deborah Mosher |
First Address | Albany, NY 12208-1708 |
Second Address | Albany, NY 12208-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2009 |
Last Update Date | 19/11/2009 |