Individual
DIAHANN CECILE MOYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
127 E 107TH ST, #615, NEW YORK, NY 10029-3939
(212) 410-4420
Mailing address
127 E 107TH ST, #615, NEW YORK, NY 10029-3939
(212) 410-4420
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
004554-1
NY
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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