Individual
MR. BABU SAMUEL MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT,DSC,ECS,MTC
Contact information
Practice address
49 CHURCH ST, FREEPORT, NY 11520-3830
(516) 623-6253
(516) 623-8450
Mailing address
579 GARFIELD RD, NORTH BALDWIN, NY 11510-1003
(516) 223-2201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7161
NY
225100000X
Physical Therapist
Primary
009705
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02088379
—
NY
Enumeration date
06/08/2006
Last updated
03/06/2019
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