Provider Demographics
NPI:1114487295
Name:MOSER, MEREDITH (DO)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:
Last Name:MOSER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6918
Mailing Address - Country:US
Mailing Address - Phone:631-268-4321
Mailing Address - Fax:631-251-5482
Practice Address - Street 1:181 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6918
Practice Address - Country:US
Practice Address - Phone:631-268-4321
Practice Address - Fax:231-220-9806
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3210282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry