Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 251610 | NY |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 251610 | NY |
NPI | 1710010103 |
---|---|
Provider Name | Jason A. Moche |
First Address | Tarrytown, NY 10591-5139 |
Second Address | New York, NY 10017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 03/04/2019 |