Individual
PAUL OTI MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
372 BAY LN, WILLSBORO, NY 12996-3649
(518) 572-1933
Mailing address
372 BAY LN, WILLSBORO, NY 12996-3649
(518) 572-1933
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
PRF000406
PA
Other
Enumeration date
06/27/2020
Last updated
06/27/2020
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