Provider Demographics
NPI:1922379353
Name:MOSKOWITZ, ERIC J (MD, MBA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 KINGS HWY STE LL-789
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2644
Mailing Address - Country:US
Mailing Address - Phone:212-844-8900
Mailing Address - Fax:
Practice Address - Street 1:3131 KINGS HWY STE LL-789
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234
Practice Address - Country:US
Practice Address - Phone:212-844-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT55148208800000X
NY279752208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology