Healthcare Provider Details

I. General information

NPI: 1669227377
Provider Name (Legal Business Name): CLARA ALEKS MOISEYEVA GC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

812 GOSHEN RD APT D10
WEST CHESTER PA
19380-4357
US

V. Phone/Fax

Practice location:
  • Phone: 302-647-2829
  • Fax:
Mailing address:
  • Phone: 614-753-9846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: