MEDICARE: BARRY DAVID MOSKOWITZ

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
1	332H00000X	Eyewear Supplier	MD015109E	PA

General Provider Information

NPI Number	:	1194909903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY DAVID MOSKOWITZ

Provider Business Mailing Address
First Line	:	1533 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1711
Country	:	US
Telephone Number	:	412-672-9765
Fax Number	:	412-672-6902

Provider Business Practice Location Address
First Line	:	1533 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1711
Country	:	US
Telephone Number	:	412-672-9765
Fax Number	:	412-672-6902

Authorized Official
Title or Position	:	MEDICAL BILLER
Name	:	MS. BEVERLY A COVER
Credential	:
Telephone Number	:	412-672-9765

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	10/26/2012

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