MEDICARE: MS. CECILIA MOY MS

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	133V00000X	Registered Dietitian	000664	NY

General Provider Information

NPI Number	:	1154395796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CECILIA MOY MS

Provider Business Mailing Address
First Line	:	12 N 7TH AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-2026
Country	:	US
Telephone Number	:	914-664-8000
Fax Number	:	914-664-8015

Provider Business Practice Location Address
First Line	:	12 N 7TH AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-2026
Country	:	US
Telephone Number	:	914-664-8000
Fax Number	:	914-664-8015

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	10/09/2007

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