Moffa, Michael A
Moffa, Michael A is an individual health care provider with primary practice located at Glacier Creek Office Park- Bldg Ii 6711 Towpath Rd., Suite 175, East Syracuse NY 13057-9510. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Moffa, Michael A can be contacted via phone (315) 458-2211.Contact Information
Primary practice address
Glacier Creek Office Park- Bldg Ii 6711 Towpath Rd., Suite 175
East Syracuse NY 13057-9510
Phone: (315) 458-2211
Fax: (315) 452-9025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 200991 | New York |
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 200991 | New York |
Profile Details
| NPI number | 1225147002 |
|---|---|
| LBN Legal business name | Moffa, Michael A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Nov 20th, 2023 - about 3 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 | 1225147002 | NPPES |
| New York | MEDICAID | 01945160 |
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