Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 1566 | VI |
N | 207V00000X | Obstetrician & Gynecologist | MD 2008-0823 | NM |
N | 207VG0400X | Gynecologist | 225641 | NY |
NPI | 1174516348 |
---|---|
Provider Name | Dr. Moise Mamouzette |
First Address | Christiansted, VI 00821-0678 |
Second Address | Christiansted, VI 00820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 17/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H78333 | (02) | NY |