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NPI Code Detail

MEDICARE: JESSICA MOSKOVICH OD

MEDICARE: JESSICA MOSKOVICH OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist009991NY

General Provider Information

NPI Number : 1194563825
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MOSKOVICH OD
Provider Business Mailing Address
First Line : 2684 E 66TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-6805
Country : US
Telephone Number : 718-210-7162
Fax Number :
Provider Business Practice Location Address
First Line : 2020 86TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-3204
Country : US
Telephone Number : 718-619-8855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2024
Last Update Date : 07/17/2024

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