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General NPI Number Information
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NPI Number | 1679994271
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Entity Type | Organization
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Legal Business Name | SPENCER T MOY OD PLLC
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Dates
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Enumeration Date | 12/27/2013
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Last Update Date | 12/27/2013
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Provider Practice Location Address
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Address Line | 128 MOTT ST STE. 303
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City | NEW YORK
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State | NY
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Zip | 10013-5540
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Country | US
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Telephone | 646-649-3430
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Fax |
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Provider Business Mailing Address
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Address Line | 128 MOTT ST STE. 303
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City | NEW YORK
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State | NY
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Zip | 10013-5540
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Country | US
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Telephone | 646-649-3430
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Fax |
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Authorized Official
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Title or Position | OD/OWNER
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Name | SPENCER T. MOY
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Credential | OD
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Telephone | 646-649-3430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 004921
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License Number State | NY
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