Provider Demographics
NPI:1528012259
Name:MOSHENYAT, YITZCHAK (MD)
Entity Type:Individual
Prefix:DR
First Name:YITZCHAK
Middle Name:
Last Name:MOSHENYAT
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 1:2044 OCEAN AVE
Mailing Address - Street 2:A3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7328
Mailing Address - Country:US
Mailing Address - Phone:718-645-8901
Mailing Address - Fax:718-645-7970
Practice Address - Street 1:2044 OCEAN AVE
Practice Address - Street 2:SUITE A3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7328
Practice Address - Country:US
Practice Address - Phone:718-645-8901
Practice Address - Fax:718-645-7970
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235908207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology