Individual
JOANNA JILL MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP, RN
Contact information
Practice address
1275 YORK AVE, 9TH FLOOR DEPARTMENT OF PEDIATRICS, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
1275 YORK AVE, 9TH FLOOR DEPARTMENT OF PEDIATRICS, NEW YORK, NY 10065-6007
(212) 639-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
541901
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
381942
NY
Other
Enumeration date
01/22/2008
Last updated
01/22/2008
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