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General NPI Number Information
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NPI Number | 1750523866
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Entity Type | Individual
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Provider Name | JACK S MOSKOWITZ DO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 2100 MARBLE CLIFF OFFICE PARK BUILDING D, SUITE A, UROLOGY SPECIALIST OF AMERICA
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City | COLUMBUS
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State | OH
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Zip | 43215
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Country | US
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Telephone | 614-403-2189
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 VININGS BLVD
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City | DUBLIN
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State | OH
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Zip | 43016-7142
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Country | US
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Telephone | 614-403-2189
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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 | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 34.009478
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | OS015697
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License Number State | PA
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