Individual
MR. MOISE KENNETH BELIZAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
140 OLD ORANGEBURG RD, ORANGEBURG, NY 10962-1157
(845) 359-1000
Mailing address
11 PARK ST, SPRING VALLEY, NY 10977-3933
(845) 826-4272
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402640-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F402640-1
NEW YORK EDUCATION DEPARTMENT
NY
Enumeration date
07/17/2019
Last updated
11/27/2023
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