Provider Demographics
NPI:1629265632
Name:MOSZKOWICZ, ARIE ISAREL (MD)
Entity Type:Individual
Prefix:
First Name:ARIE
Middle Name:ISAREL
Last Name:MOSZKOWICZ
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:PO BOX 2030
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-2030
Mailing Address - Country:US
Mailing Address - Phone:855-381-9178
Mailing Address - Fax:
Practice Address - Street 1:2001 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3320
Practice Address - Country:US
Practice Address - Phone:915-577-6011
Practice Address - Fax:915-577-7068
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD720092085R0202X
TXP54312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM83103767Medicaid
TX88FA286FA286OtherTRICARE/TRI WEST
TX8FA286OtherBCBS TX
TXP01546381OtherTX RAILROAD MEDICARE
TX322712601/02CSNMedicaid
TXP01546381OtherTX RAILROAD MEDICARE