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NPI Code Detail

MEDICARE: SOPHIA MOYER PA-C

MEDICARE: SOPHIA MOYER PA-C
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
1363AS0400XSurgical Physician Assistant019181NY

General Provider Information

NPI Number : 1336519131
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA MOYER PA-C
Provider Business Mailing Address
First Line : 440 SAINT JOHNS PL
Second Line : APT 4A
City : BROOKLYN
State : NY
Zip : 11238-5349
Country : US
Telephone Number : 413-219-7509
Fax Number :
Provider Business Practice Location Address
First Line : 150 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-2508
Country : US
Telephone Number : 718-630-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2015
Last Update Date : 10/06/2015

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Directions to “ SOPHIA MOYER PA-C” Practice Location

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