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NPI Code Detail

MEDICARE: KYLA MOUSTACHETTI

MEDICARE: KYLA MOUSTACHETTI
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1861340945
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLA MOUSTACHETTI
Provider Business Mailing Address
First Line : 250 UTICA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-3931
Country : US
Telephone Number : 609-873-9747
Fax Number :
Provider Business Practice Location Address
First Line : 250 UTICA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-3931
Country : US
Telephone Number : 718-953-9011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ KYLA MOUSTACHETTI ” Practice Location

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