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General NPI Number Information
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NPI Number | 1700036795
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Entity Type | Organization
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Legal Business Name | MOEHLEN MEDICAL GROUP PC
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 128 E 75TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-3291
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Country | US
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Telephone | 212-737-6222
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Fax | 212-570-9362
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Provider Business Mailing Address
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Address Line | 128 E 75TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-3291
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Country | US
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Telephone | 212-737-6222
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Fax | 212-570-9362
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KARL-HEINZ MOEHLEN
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Credential | M.D.
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Telephone | 212-737-6222
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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 | 145561
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License Number State | NY
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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 | 156500
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License Number State | NY
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