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General NPI Number Information
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NPI Number | 1083415087
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Entity Type | Individual
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Provider Name | MOET STEWART
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 39 N PLANK RD STE 12
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City | NEWBURGH
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State | NY
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Zip | 12550-2117
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Country | US
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Telephone | 646-926-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 1849 SOUTH RD # 1029
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-1360
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Country | US
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Telephone | 646-929-0443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 22ST1382708
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State | NY
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