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General NPI Number Information
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NPI Number | 1174516348
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Entity Type | Individual
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Provider Name | MOISE MAMOUZETTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 201-202 ESTATE RUBY
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-692-6263
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Fax | 340-778-4922
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Provider Business Mailing Address
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Address Line | PO BOX 678
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City | CHRISTIANSTED
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State | VI
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Zip | 00821-0678
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Country | US
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Telephone | 340-692-6263
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Fax | 340-778-4922
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD 2008-0823
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 1566
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License Number State | VI
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 225641
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License Number State | NY
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