Provider Demographics
NPI:1477608925
Name:MOADEL, MINOO (CSW)
Entity Type:Individual
Prefix:MS
First Name:MINOO
Middle Name:
Last Name:MOADEL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GABRIELE DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1337
Mailing Address - Country:US
Mailing Address - Phone:516-922-3550
Mailing Address - Fax:516-922-3550
Practice Address - Street 1:34 GABRIELE DR
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1337
Practice Address - Country:US
Practice Address - Phone:516-922-3550
Practice Address - Fax:516-922-3550
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO19660-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical