Provider Demographics
NPI:1912047309
Name:MOSKOWITZ, TAMAR F (MS, CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:F
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:MS, CCC SLP
Other - Prefix:MS
Other - First Name:TAMAR
Other - Middle Name:F
Other - Last Name:LICHTENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:302 LONGACRE AVE
Mailing Address - Street 2:APT. #B-4
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2551
Mailing Address - Country:US
Mailing Address - Phone:347-756-0649
Mailing Address - Fax:
Practice Address - Street 1:921 E NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1309
Practice Address - Country:US
Practice Address - Phone:718-778-8587
Practice Address - Fax:718-735-8938
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014328-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400015181OtherMEDICARE PTAN