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General NPI Number Information
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NPI Number | 1013082130
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Entity Type | Organization
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Legal Business Name | JOEL MOSES MD PLLC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 350 NORTHERN BLVD SUITE 108
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 518-462-9675
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Fax | 518-729-3444
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Provider Business Mailing Address
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Address Line | 350 NORTHERN BLVD SUITE 108
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 518-462-9675
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Fax | 518-729-3444
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL E MOSES
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Credential | M.D.
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Telephone | 518-462-9675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 185876
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License Number State | NY
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