Provider Demographics
NPI:1033531173
Name:MOSIER, VIRGINIA (CNIM)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:MOSIER
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 W RAMBO ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19405-1126
Mailing Address - Country:US
Mailing Address - Phone:610-613-6068
Mailing Address - Fax:
Practice Address - Street 1:1086 TEANECK RD
Practice Address - Street 2:SUITE 4A
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4854
Practice Address - Country:US
Practice Address - Phone:201-862-9900
Practice Address - Fax:201-862-9136
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1526246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic