Provider Demographics
NPI:1184869588
Name:MOSCHOS, ANASTASIOS (PT)
Entity type:Individual
Prefix:MR
First Name:ANASTASIOS
Middle Name:
Last Name:MOSCHOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 CENTRAL PARK AVE
Mailing Address - Street 2:#5405
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1059
Mailing Address - Country:US
Mailing Address - Phone:917-405-6160
Mailing Address - Fax:718-803-8130
Practice Address - Street 1:508 CENTRAL PARK AVE
Practice Address - Street 2:#5405
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1059
Practice Address - Country:US
Practice Address - Phone:917-405-6160
Practice Address - Fax:718-803-8130
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist