Moallem, Anita Gross
Moallem, Anita Gross is an individual health care provider with primary practice located at 4355 147Th St , Flushing NY 11355-1736. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Moallem, Anita Gross can be contacted via phone (718) 762-0900.Contact Information
Primary practice address
4355 147Th St
Flushing NY 11355-1736
Phone: (718) 762-0900
Fax: (718) 886-5659
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 095345 | New York |
Profile Details
| NPI number | 1932146339 |
|---|---|
| LBN Legal business name | Moallem, Anita Gross |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932146339 | NPPES |
| New York | Other | 10459014 | CAQH |
| New York | MEDICAID | 00549293 | CAQH |
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