Provider Demographics
NPI:1629061262
Name:MOSKOWITZ, NANCY LYN (DPM)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LYN
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:615 BROADWAY
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1039
Mailing Address - Country:US
Mailing Address - Phone:914-478-3550
Mailing Address - Fax:914-478-3503
Practice Address - Street 1:615 BROADWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-1039
Practice Address - Country:US
Practice Address - Phone:914-478-3550
Practice Address - Fax:914-478-3503
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2010-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYN005060213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01643732Medicaid
NY01643732Medicaid
NYP63211Medicare PIN
NY6366930001Medicare NSC