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Individual

MRS. TINA ALLYN MOSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
2 LONGLEAF MDWS, CLIFTON PARK, NY 12065-2134
(518) 877-8716
Mailing address
2 LONGLEAF MDWS, CLIFTON PARK, NY 12065-2134
(518) 877-8716

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
009429-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009429-1
LINCENSE #
NY
Enumeration date
11/08/2010
Last updated
11/08/2010
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