Provider Demographics
NPI:1598224206
Name:MOY, AUSTIN
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:MOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PINE DR
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-2205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 PINE DR
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08510-2205
Practice Address - Country:US
Practice Address - Phone:848-219-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty