Provider Demographics
NPI:1932779303
Name:MOSHER, ANNA (AUD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MOSHER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:FYALKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:6700 KIRKVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9373
Mailing Address - Country:US
Mailing Address - Phone:315-463-1724
Mailing Address - Fax:
Practice Address - Street 1:6700 KIRKVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9373
Practice Address - Country:US
Practice Address - Phone:315-463-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty