Individual
MS. DORIT BEN-MOHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
420 N BROADWAY, JERICHO, NY 11753-2135
(516) 827-1515
(516) 342-6505
Mailing address
420 N BROADWAY, JERICHO, NY 11753-2135
(516) 827-1515
(516) 342-6505
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
209201
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01990629
—
NY
Enumeration date
10/11/2006
Last updated
05/20/2019
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