Provider Demographics
NPI:1619105251
Name:MOSKOVITZ, NEIL (DPT)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:MOSKOVITZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 ATLANTIC AVE.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6792
Mailing Address - Country:US
Mailing Address - Phone:718-852-6030
Mailing Address - Fax:718-852-5290
Practice Address - Street 1:161 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6792
Practice Address - Country:US
Practice Address - Phone:718-852-6030
Practice Address - Fax:718-852-5290
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031012-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist