MEDICARE: MARCELLA MOSLOW

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	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor		NY

General Provider Information

NPI Number	:	1336679869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELLA MOSLOW

Provider Business Mailing Address
First Line	:	474 NIAGARA FALLS BLVD STE 5
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-2647
Country	:	US
Telephone Number	:	716-867-5027
Fax Number	:

Provider Business Practice Location Address
First Line	:	474 NIAGARA FALLS BLVD STE 5
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-2647
Country	:	US
Telephone Number	:	716-867-5027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2017
Last Update Date	:	02/19/2021

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Directions to “ MARCELLA MOSLOW ” Practice Location

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