Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 291377 | NY |
N | 111NI0900X | Internist | 291377 | NY |
N | 207R00000X | Internist | C1-0012476 | DE |
N | 111NI0900X | Internist | C1-0012476 | DE |
Y | 207RH0002X | Hospice and Palliative Medicine | 291377 | NY |
NPI | 1366857468 |
---|---|
Provider Name | Michael G Moskovitz |
First Address | Stony Brook, NY 11794 |
Second Address | Stony Brook, NY 11794 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 14/10/2020 |