Organization
YASMEEN A MOODY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YASMEEN A MOODY MD (OWNER)
(607) 535-4644
Entity
Organization
Contact information
Practice address
1 FIRST STREET, WATKINS GLEN, NY 14891
(607) 535-4644
(607) 535-4744
Mailing address
PO BOX 366, 202 TAUGHANNOCK BLVD, ITHACA, NY 14851-0366
(607) 277-3257
(607) 277-4056
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01487916
—
NY
Enumeration date
05/15/2006
Last updated
02/05/2008
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