MEDICARE: SAM MOSKOWITZ, M.D., PC

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	207RG0100X	Gastroenterology Physician	131584	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1912105321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAM MOSKOWITZ, M.D., PC

Provider Business Mailing Address
First Line	:	2035 RALPH AVE STE A2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5300
Country	:	US
Telephone Number	:	171-833-8262
Fax Number	:	718-377-3598

Provider Business Practice Location Address
First Line	:	5124 AVENUE N
Second Line	:	ENTRANCE E 52 ST
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3815
Country	:	US
Telephone Number	:	718-338-2621
Fax Number	:	718-377-3598

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PEARL STORCH
Credential	:
Telephone Number	:	718-338-2621

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	06/11/2024

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