Provider Demographics
NPI:1861035727
Name:MOSHIER, MARY-ELIZABETH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MARY-ELIZABETH
Middle Name:
Last Name:MOSHIER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1427
Mailing Address - Country:US
Mailing Address - Phone:518-463-0171
Mailing Address - Fax:
Practice Address - Street 1:116 EVERETT RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1427
Practice Address - Country:US
Practice Address - Phone:518-463-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY707533163WN0800X
NYF346127208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience