Provider Demographics
NPI:1194235150
Name:MOSES, LEE ANGELIA (PHD)
Entity type:Individual
Prefix:DR
First Name:LEE ANGELIA
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 VIRGINIA AVE STE 201B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30337-2898
Mailing Address - Country:US
Mailing Address - Phone:470-736-3600
Mailing Address - Fax:404-201-9396
Practice Address - Street 1:330 AUBURN POINTE DR SE UNIT 8306
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1778
Practice Address - Country:US
Practice Address - Phone:404-314-9189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment