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General NPI Number Information
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NPI Number | 1619640943
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Entity Type | Individual
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Provider Name | EMILY MOSS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 05/25/2025
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Provider Practice Location Address
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Address Line | 1345 MOTOR PKWY FL 1
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City | ISLANDIA
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State | NY
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Zip | 11749-5208
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Country | US
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Telephone | 516-616-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 125 MINEOLA AVE STE 200
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2042
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Country | US
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Telephone |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 026926
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License Number State | NY
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