Individual
HESTER EILEEN MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 BERGEN ST, BROOKLYN, NY 11217
(212) 420-2600
Mailing address
207 BERGEN ST, BROOKLYN, NY 11217
(718) 643-2311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001467-1
NY
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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