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General NPI Number Information
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NPI Number | 1750540688
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Entity Type | Individual
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Provider Name | DIANA ELENA MOGA M.D.,PH.D., P.C.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 139 W 82ND ST STE 1CD
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City | NEW YORK
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State | NY
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Zip | 10024-5544
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Country | US
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Telephone | 468-310-3796
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Fax | 866-586-5679
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Provider Business Mailing Address
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Address Line | 139 W 82ND ST STE 1CD
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City | NEW YORK
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State | NY
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Zip | 10024-5544
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Country | US
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Telephone | 468-310-3796
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Fax | 866-586-5679
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 003456
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 267189
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License Number State | NY
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