Provider Demographics
NPI:1073548111
Name:MOSKOWITZ, ANDREA (DPT)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:WASSERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:200 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1769
Mailing Address - Country:US
Mailing Address - Phone:310-273-8256
Mailing Address - Fax:
Practice Address - Street 1:200 N ROBERTSON BLVD
Practice Address - Street 2:#301
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1769
Practice Address - Country:US
Practice Address - Phone:310-273-8256
Practice Address - Fax:310-273-8542
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist