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General NPI Number Information
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NPI Number | 1841362753
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Entity Type | Individual
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Provider Name | JOHN MOISES PT
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 38 W 32ND ST SUITE 501
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City | NEW YORK
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State | NY
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Zip | 10001-3816
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Country | US
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Telephone | 212-868-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 7A MONTAUK PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1827
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Country | US
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Telephone | 718-370-0736
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 019626-1
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License Number State | NY
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