Healthcare Provider Details

I. General information

NPI: 1457784068
Provider Name (Legal Business Name): JAMES MOY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BARRETT DR
WEBSTER NY
14580-2963
US

IV. Provider business mailing address

60 BARRETT DR
WEBSTER NY
14580-2963
US

V. Phone/Fax

Practice location:
  • Phone: 585-875-7575
  • Fax:
Mailing address:
  • Phone: 585-875-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI056683
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: