MEDICARE: MOYA DARNELL DUNLAP LMSW

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	104100000X	Social Worker	72P68973	NY

General Provider Information

NPI Number	:	1841431483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOYA DARNELL DUNLAP LMSW

Provider Business Mailing Address
First Line	:	1336 ODELL ST.
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462
Country	:	US
Telephone Number	:	718-285-0553
Fax Number	:

Provider Business Practice Location Address
First Line	:	274 W 145TH ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039-4122
Country	:	US
Telephone Number	:	212-368-4100
Fax Number	:	212-282-5041

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

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/11/2009

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