Provider Demographics
NPI:1457538936
Name:MOSHENYAT'S GASTROENTEROLOGY O.B.S., P.C.
Entity Type:Organization
Organization Name:MOSHENYAT'S GASTROENTEROLOGY O.B.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YITZCHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHENYAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-645-8901
Mailing Address - Street 1:2044 OCEAN AVE
Mailing Address - Street 2:SUITE A3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7328
Mailing Address - Country:US
Mailing Address - Phone:718-645-8901
Mailing Address - Fax:718-645-7970
Practice Address - Street 1:2044 OCEAN AVE
Practice Address - Street 2:SUITE A3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7328
Practice Address - Country:US
Practice Address - Phone:718-645-8901
Practice Address - Fax:718-645-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-27
Last Update Date:2008-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235908261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWHW131Medicare UPIN
NY4V7191Medicare UPIN