Provider Demographics
NPI:1376815837
Name:MOSBACHER, AMY M (LMT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:MOSBACHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
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Mailing Address - Street 1:2 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2727
Mailing Address - Country:US
Mailing Address - Phone:845-594-7807
Mailing Address - Fax:845-613-1095
Practice Address - Street 1:521 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1609
Practice Address - Country:US
Practice Address - Phone:845-594-7807
Practice Address - Fax:845-613-1095
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005307-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist