Individual
BLYTHE MOEBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
67 REGINA RD, AIRMONT, NY 10952-4526
(917) 202-1839
Mailing address
67 REGINA RD, AIRMONT, NY 10952-4526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
745578
NY
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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