Provider Demographics
NPI:1740582238
Name:MOSES, SATA (LPN)
Entity Type:Individual
Prefix:
First Name:SATA
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GLENWOOD AVE
Mailing Address - Street 2:1APT-12M
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-2164
Mailing Address - Country:US
Mailing Address - Phone:718-671-2100
Mailing Address - Fax:
Practice Address - Street 1:1 GLENWOOD AVE
Practice Address - Street 2:1APT-12M
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2164
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303805164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse