Provider Demographics
NPI:1447462742
Name:MOSKOWITZ, LISA J (MA,NYSTATE LICENCE)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:J
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:MA,NYSTATE LICENCE
Other - Prefix:
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Mailing Address - Street 1:215 W 90TH ST
Mailing Address - Street 2:4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1221
Mailing Address - Country:US
Mailing Address - Phone:212-874-7543
Mailing Address - Fax:646-290-7500
Practice Address - Street 1:215 W 90TH ST
Practice Address - Street 2:4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1221
Practice Address - Country:US
Practice Address - Phone:212-874-7543
Practice Address - Fax:646-290-7500
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000606-01102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst