Individual provider · Type 1 NPI
Kenneth Allen Moberg, NURSE PRACTITIONER
Adult Health Nurse Practitioner · New York, NY
NPI number
1033379540
Active
Practice location
121B West 20th Street, Village Diagnostic & Treatment Center
New York, NY 10011
Fax (212) 337-9275
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | F302611-1 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1033379540
Kenneth Allen Moberg, NURSE PRACTITIONER's National Provider Identifier is 1033379540, issued on Jun 10, 2008. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in New York, NY. The record was last updated on Aug 27, 2013.