Individual
DR. CAROLE LYSAGHT MOODHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 PRO HEALTH PLZ, NEW HYDE PARK, NY 11042-1111
(516) 506-6885
(516) 608-6824
Mailing address
2 PRO HEALTH PLZ, NEW HYDE PARK, NY 11042-1111
(516) 506-6885
(516) 608-6824
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
181854
NY
207R00000X
Internal Medicine Physician
Primary
181854
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00738981
—
NY
05
—
01437714
—
NY
01
—
06399
GHI MEDICARE
NY
01
—
260AD1
EMPIRE BCBS MEDICARE
NY
01
—
62K521
EMPIRE MEDICARE
NY
01
—
AP603
OXFORD MEDICARE
NY
Enumeration date
11/07/2006
Last updated
07/15/2025
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