Provider Demographics
NPI:1194933432
Name:MOENICH, MARGARET MARY (MS, LAC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:MOENICH
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E 21ST ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7405
Mailing Address - Country:US
Mailing Address - Phone:212-228-1187
Mailing Address - Fax:
Practice Address - Street 1:244 E 21ST ST
Practice Address - Street 2:APT. 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7405
Practice Address - Country:US
Practice Address - Phone:212-228-1187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist