Provider Demographics
NPI:1972779122
Name:MOSKOW, ADAM (AP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:MOSKOW
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1627
Mailing Address - Country:US
Mailing Address - Phone:954-675-5189
Mailing Address - Fax:
Practice Address - Street 1:2720 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1627
Practice Address - Country:US
Practice Address - Phone:954-675-5189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2520171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist