Individual
DR. RICHARD T. MOXLEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-5006
(585) 273-1255
Mailing address
601 ELMWOOD AVE, BOX 673, ROCHESTER, NY 14642-0001
(585) 275-5006
(585) 273-1255
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
120854
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00639652
—
NY
Enumeration date
08/21/2006
Last updated
01/23/2012
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