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NPI Code Detail

MEDICARE: MS. SUSAN ELIZABETH MOSCOU FNP, PMHNP

MEDICARE: MS. SUSAN ELIZABETH MOSCOU FNP, PMHNP
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
1363LF0000XFamily Nurse Practitioner331167NY
2363LP0808XPsychiatric/Mental Health Nurse Practitioner404747NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841330891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN ELIZABETH MOSCOU FNP, PMHNP
Provider Business Mailing Address
First Line : 555 BROADWAY # MH275
Second Line :
City : DOBBS FERRY
State : NY
Zip : 10522-1186
Country : US
Telephone Number : 914-674-7866
Fax Number :
Provider Business Practice Location Address
First Line : 555 BROADWAY
Second Line : MEH 16
City : DOBBS FERRY
State : NY
Zip : 10522-1186
Country : US
Telephone Number : 914-674-7866
Fax Number : 914-674-7623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 12/22/2023

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