Healthcare Provider Details

I. General information

NPI: 1023340908
Provider Name (Legal Business Name): STEVE MOYIK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 ROUTE 202
POMONA NY
10970-2901
US

IV. Provider business mailing address

12 ARDMORE ST
NEW WINDSOR NY
12553-8304
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-8980
  • Fax: 845-354-7665
Mailing address:
  • Phone: 845-534-3735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number041773-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: