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NPI Code Detail

MEDICARE: DR. JAIME MOYA M.D.

MEDICARE:  DR. JAIME  MOYA  M.D.
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
1208D00000XGeneral Practice PhysicianMA 023442NJ

General Provider Information

NPI Number : 1275782310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIME MOYA M.D.
Provider Business Mailing Address
First Line : 471 JEFFERSON AVE
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-2631
Country : US
Telephone Number : 201-393-9268
Fax Number :
Provider Business Practice Location Address
First Line : 471 JEFFERSON AVE
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-2631
Country : US
Telephone Number : 201-393-9268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2008
Last Update Date : 09/13/2008

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