Provider Demographics
NPI:1225314867
Name:MOSKOWITZ, RIVKA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 EASTERN PKWY APT E18
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3417
Mailing Address - Country:US
Mailing Address - Phone:312-343-1797
Mailing Address - Fax:
Practice Address - Street 1:26 BROADWAY STE 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1703
Practice Address - Country:US
Practice Address - Phone:212-335-0236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY637019163W00000X
NY403203363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse