Individual
KRISTA ANN MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2539 MIDDLE COUNTRY RD, CENTEREACH, NY 11720-3551
(631) 737-6434
(631) 738-1226
Mailing address
384 W 18TH ST, DEER PARK, NY 11729-6340
(631) 456-1646
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402526
NY
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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