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NPI Code Detail

MEDICARE: DR. WESNER MOISE MD

MEDICARE: DR. WESNER MOISE MD
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
1207R00000XInternal Medicine Physician121660NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528122314
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WESNER MOISE MD
Provider Business Mailing Address
First Line : 248 W 35TH ST
Second Line : 8TH FLOOR
City : NEW YORK
State : NY
Zip : 10001-2505
Country : US
Telephone Number : 855-681-8700
Fax Number : 646-380-1322
Provider Business Practice Location Address
First Line : 2412 CHURCH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-4005
Country : US
Telephone Number : 855-681-8700
Fax Number : 646-380-1322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 12/19/2016

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