Provider Demographics
NPI:1730213430
Name:MOSHCHINSKY, MARK (LAC (NCCAOM))
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:MOSHCHINSKY
Suffix:
Gender:M
Credentials:LAC (NCCAOM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 W 5TH ST APT 21H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3958
Mailing Address - Country:US
Mailing Address - Phone:212-533-1192
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3241
Practice Address - Country:US
Practice Address - Phone:212-533-1192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist