Provider Demographics
NPI:1144384736
Name:MOETZINGER, CAROL ANN GREENAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN GREENAN
Last Name:MOETZINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-1405
Mailing Address - Country:US
Mailing Address - Phone:845-429-9035
Mailing Address - Fax:845-429-9035
Practice Address - Street 1:6 LOCUST DR
Practice Address - Street 2:
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984-1405
Practice Address - Country:US
Practice Address - Phone:845-429-9035
Practice Address - Fax:845-429-9035
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily