Healthcare Provider Details

I. General information

NPI: 1083577571
Provider Name (Legal Business Name): SHARA MOSKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 ROUTE 520
MIDDLESEX NJ
00726
US

IV. Provider business mailing address

14 ROUTE 520
MIDDLESEX NJ
00726
US

V. Phone/Fax

Practice location:
  • Phone: 732-334-8046
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT00257000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: