Healthcare Provider Details

I. General information

NPI: 1750870622
Provider Name (Legal Business Name): MOSHE SOSKIN EMTB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5369 KINGS HWY
BROOKLYN NY
11203-6704
US

IV. Provider business mailing address

5369 KINGS HWY
BROOKLYN NY
11203-6704
US

V. Phone/Fax

Practice location:
  • Phone: 718-298-2222
  • Fax: 718-298-3333
Mailing address:
  • Phone: 718-298-2222
  • Fax: 718-298-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: