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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH MOFFATT JR. PH.D.

MEDICARE: DR. MICHAEL JOSEPH MOFFATT JR. PH.D.
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
1103TC0700XClinical Psychologist013755NY
2103TS0200XSchool PsychologistNY

General Provider Information

NPI Number : 1730386855
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH MOFFATT JR. PH.D.
Provider Business Mailing Address
First Line : 19 CAMEO CT
Second Line : RURAL ROUTE 9
City : CARMEL
State : NY
Zip : 10512-2230
Country : US
Telephone Number : 914-948-9411
Fax Number : 845-277-2137
Provider Business Practice Location Address
First Line : 12 OLD MAMARONECK RD
Second Line : SUITE 1H
City : WHITE PLAINS
State : NY
Zip : 10605-2010
Country : US
Telephone Number : 914-948-9411
Fax Number : 845-277-2137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2007
Last Update Date : 09/11/2025

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