Provider Demographics
NPI:1508347873
Name:MOSHENYAT LLC
Entity Type:Organization
Organization Name:MOSHENYAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHENYAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-645-8901
Mailing Address - Street 1:1958 OCEAN AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6719
Mailing Address - Country:US
Mailing Address - Phone:718-645-8901
Mailing Address - Fax:718-645-7970
Practice Address - Street 1:1958 OCEAN AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6719
Practice Address - Country:US
Practice Address - Phone:718-645-8901
Practice Address - Fax:718-645-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty