Provider Demographics
NPI:1013547165
Name:MOSCA, YULY SIERRA
Entity Type:Individual
Prefix:
First Name:YULY
Middle Name:SIERRA
Last Name:MOSCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YULY
Other - Middle Name:PAOLA
Other - Last Name:SIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:YULY SIERRA
Mailing Address - Street 1:5 ERIE ST
Mailing Address - Street 2:CAMBRIDGE
Mailing Address - City:MA
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3215
Mailing Address - Country:US
Mailing Address - Phone:978-625-2381
Mailing Address - Fax:
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:617-665-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2322286163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice