Individual
LUCY MOSHKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1854 HYLAN BLVD, STATEN ISLAND, NY 10305-2119
(917) 553-0424
Mailing address
220 FINLEY AVE, STATEN ISLAND, NY 10306-5649
(718) 980-6787
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2930869
NY
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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