MEDICARE: STANLEY MOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835I0206X	Infectious Diseases Pharmacist	I059525	NY
2	183500000X	Pharmacist	28RI03438300	NJ

General Provider Information

NPI Number	:	1114208345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY MOY

Provider Business Mailing Address
First Line	:	445 LENOX RD # 36
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2017
Country	:	US
Telephone Number	:	718-270-4121
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 LENOX RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2017
Country	:	US
Telephone Number	:	718-270-4121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2011
Last Update Date	:	04/09/2023

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Directions to “ STANLEY MOY ” Practice Location

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