Provider Demographics
NPI:1720203946
Name:MOSKOWITZ, DAVID B (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2017
Mailing Address - Country:US
Mailing Address - Phone:845-291-1301
Mailing Address - Fax:
Practice Address - Street 1:102 GREEN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2017
Practice Address - Country:US
Practice Address - Phone:845-291-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047956101YM0800X, 102L00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11301559OtherCAQH PROVIDER #
NY11301559OtherCAQH PROVIDER #