MEDICARE: ABYGAILE MAE MOISES P.T.

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	225100000X	Physical Therapist	024096	NY

General Provider Information

NPI Number	:	1811188691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABYGAILE MAE MOISES P.T.

Provider Business Mailing Address
First Line	:	3617 CORLEAR AVENUE
Second Line	:	11
City	:	BRONS
State	:	NY
Zip	:	10463
Country	:	US
Telephone Number	:	646-269-2580
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 EASTCHESTER RD
Second Line	:	214
City	:	BRONX
State	:	NY
Zip	:	10469-5947
Country	:	US
Telephone Number	:	718-653-6400
Fax Number	:	718-653-3333

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

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	10/04/2011

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