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Organization

SOUTH CARRIAGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN MORIARTY DPM (PHYSICIAN)
(585) 331-6752
Entity
Organization

Contact information

Practice address
512 BEACH DR, MEDINA, NY 14103-1004
(585) 331-6752
(585) 331-6752
Mailing address
PO BOX 70243, STATEN ISLAND, NY 10307-0243
(585) 331-6752

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
006888
NY

Other

Enumeration date
10/10/2017
Last updated
10/10/2017
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