Provider Demographics
NPI:1740693662
Name:MOISA, ROBBIN BURA (MD)
Entity type:Individual
Prefix:DR
First Name:ROBBIN
Middle Name:BURA
Last Name:MOISA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18465 MIDLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1527
Mailing Address - Country:US
Mailing Address - Phone:917-834-0554
Mailing Address - Fax:
Practice Address - Street 1:18465 MIDLAND PKWY
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1527
Practice Address - Country:US
Practice Address - Phone:917-834-0554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163543207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease