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Individual

DR. IRA MOSES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., ABPP

Contact information

Practice address
20 WEST 74TH ST., NEW YORK, NY 10023
(203) 777-5119
Mailing address
20 WEST 74TH ST, NEW YORK, NY 10023
(212) 873-2992

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6046
NY
103T00000X
Psychologist
669
CT

Other

Enumeration date
07/05/2006
Last updated
08/17/2011
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