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NPI Code Detail

MEDICARE: MICHELLE MOY PHARMD

MEDICARE: MICHELLE MOY PHARMD
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
13336C0003XCommunity/Retail Pharmacy064515NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1527624698OTHERNYDRIVER'S LICENSE

General Provider Information

NPI Number : 1639650864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MOY PHARMD
Provider Business Mailing Address
First Line : 6910 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-1305
Country : US
Telephone Number : 718-680-2229
Fax Number : 718-680-0228
Provider Business Practice Location Address
First Line : 6910 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-1305
Country : US
Telephone Number : 718-680-2229
Fax Number : 718-680-0228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2018
Last Update Date : 08/26/2018

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