Healthcare Provider Details

I. General information

NPI: 1205123197
Provider Name (Legal Business Name): REUT MOYAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 WHITE PLAINS RD
SCARSDALE NY
10583-5028
US

IV. Provider business mailing address

696 WHITE PLAINS RD
SCARSDALE NY
10583-5028
US

V. Phone/Fax

Practice location:
  • Phone: 914-723-7000
  • Fax: 914-723-7002
Mailing address:
  • Phone: 914-723-7000
  • Fax: 914-723-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number280732
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number280732
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: