Organization
MARIE JACQUELINE MOISES MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE JACQUELINE MOISES (SOLE PROPRIETOR)
(718) 740-3106
Entity
Organization
Contact information
Practice address
21517 JAMAICA AVE, QUEENS VILLAGE, NY 11428-1715
(718) 740-3106
Mailing address
21517 JAMAICA AVE, QUEENS VILLAGE, NY 11428-1715
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
151357
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01163859
—
NY
Enumeration date
04/03/2006
Last updated
08/22/2020
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