MEDICARE: NICOLE MOYSAK

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	363LF0000X	Family Nurse Practitioner	358889	NY

General Provider Information

NPI Number	:	1528992427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MOYSAK

Provider Business Mailing Address
First Line	:	440 HAMILTON AVE APT 402
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601-1932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 GRACE CHURCH ST
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4911
Country	:	US
Telephone Number	:	914-632-2737
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

Similar Medicare Providers

1104867761 — PATRICIA MARIE MAHONEY C.N.M.
Practice Location Address:

5 GRACE CHURCH ST
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax: 914-937-7932

1093821076 — PATRICIA LABRUNDA O.D
Practice Location Address:

5 GRACE CHURCH ST , OPTOMETRY
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax: 914-406-8228

1053494112 — PAULETTE P PORTEOUS-COLE D.D.S.
Practice Location Address:

5 GRACE CHURCH ST
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax:

1063598902 — SHARON P TYNDALL MD
Practice Location Address:

5 GRACE CHURCH ST
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax: 914-937-7932

1124180278 — VALSAMMA SAMUEL MD
Practice Location Address:

5 GRACE CHURCH ST , OPEN DOOR FAMILY MEDICAL CENTERS, INC.
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax:

1396807442 — MARGARET STATILE NP
Practice Location Address:

5 GRACE CHURCH ST , OPEN DOOR FAMILY MEDICAL CENTERS, INC.
PORT CHESTER, NY
10573-4911

Practice Phone: 914-937-8899
Practice Fax:

Directions to “ NICOLE MOYSAK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.