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Individual

SHUBAN K MOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
267 HILL RD, SUITE 300, ROME, NY 13441-4203
(315) 337-0202
(315) 356-4967
Mailing address
267 HILL RD, SUITE 300, ROME, NY 13441-4203
(315) 337-0202
(315) 356-4967

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
119257
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00567620
NY
01
C5119257
WORKERS COMP
NY
Enumeration date
07/27/2005
Last updated
01/21/2013
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