MEDICARE: MOYA HEYWARD

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	1041C0700X	Clinical Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1821137027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOYA HEYWARD

Provider Business Mailing Address
First Line	:	5712 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4021
Country	:	US
Telephone Number	:	302-384-2610
Fax Number	:

Provider Business Practice Location Address
First Line	:	5712 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4021
Country	:	US
Telephone Number	:	718-804-5529
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/13/2024

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Directions to “ MOYA HEYWARD ” Practice Location

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