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Individual

MR. MOSHE A MAYFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
211 E 79TH ST, NEW YORK, NY 10075-0819
(212) 879-1600
Mailing address
2025 CRESCENT ST, 2B, ASTORIA, NY 11105-4316
(347) 724-1180

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
695125
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F309119
NY

Other

Enumeration date
06/18/2015
Last updated
07/28/2019
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