Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 300435-01 | NY |
NPI | 1013379452 |
---|---|
Provider Name | Dr. Andrew Moses |
First Address | New York, NY 10075-1850 |
Second Address | New York, NY 10075-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 20/08/2021 |