Provider Demographics
NPI:1295757300
Name:MOSHKOVICH, EVGENIY (MD)
Entity type:Individual
Prefix:
First Name:EVGENIY
Middle Name:
Last Name:MOSHKOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 86TH ST
Mailing Address - Street 2:DBAL CITYMD URGENT CARE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3205
Mailing Address - Country:US
Mailing Address - Phone:646-828-6401
Mailing Address - Fax:
Practice Address - Street 1:2175 86TH ST
Practice Address - Street 2:DBA: CITY MD
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3205
Practice Address - Country:US
Practice Address - Phone:646-828-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240208207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2714QWS101Medicare PIN