Individual
MR. BEN ROBERT MOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
114 GILLETTE AVE, PATCHOGUE, NY 11772-2515
(631) 730-5212
Mailing address
114 GILLETTE AVE, PATCHOGUE, NY 11772-2515
(631) 730-5212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0096411
NY
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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