Provider Demographics
NPI:1306028626
Name:MOSKOWITZ, JEFFREY PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:PAUL
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:207 E 74TH ST
Mailing Address - Street 2:APT 4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3342
Mailing Address - Country:US
Mailing Address - Phone:212-472-6525
Mailing Address - Fax:212-472-6525
Practice Address - Street 1:207 E 74TH ST
Practice Address - Street 2:APT 4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3342
Practice Address - Country:US
Practice Address - Phone:908-265-2077
Practice Address - Fax:347-486-6127
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY164627207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00956363Medicaid