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General NPI Number Information
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NPI Number | 1235363953
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Entity Type | Individual
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Provider Name | MAUREEN TIERNEY MOYNIHAN RN
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Gender | Female
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 424 W 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-2321
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Country | US
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Telephone | 212-695-3444
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Fax | 212-695-0242
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Provider Business Mailing Address
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Address Line | 58 JEFFERSON ST
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City | GARDEN CITY
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State | NY
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Zip | 11530-3914
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Country | US
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Telephone | 516-354-0192
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Fax | 516-354-0860
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 400960
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License Number State | NY
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