Individual
KENGWA COREY MOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10075-1850
(212) 434-2000
Mailing address
1901 1ST AVE, NEW YORK, NY 10029-7404
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
312705
NY
Other
Enumeration date
05/14/2017
Last updated
09/06/2024
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