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Individual

MS. EILEEN MOYNIHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(646) 996-5946
Mailing address
3618 CORLEAR AVE, BRONX, NY 10463-2306
(646) 996-5946

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6128
CT
363L00000X
Nurse Practitioner
95011169
CA
363LF0000X
Family Nurse Practitioner
Primary
339111
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05323244
NY
Enumeration date
09/10/2014
Last updated
06/13/2022
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