MEDICARE: MR. JOHN MOISES PT

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	019626-1	NY

General Provider Information

NPI Number	:	1841362753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN MOISES PT

Provider Business Mailing Address
First Line	:	7A MONTAUK PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1827
Country	:	US
Telephone Number	:	718-370-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 W 32ND ST
Second Line	:	SUITE 501
City	:	NEW YORK
State	:	NY
Zip	:	10001-3816
Country	:	US
Telephone Number	:	212-868-0509
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. JOHN MOISES PT” Practice Location

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