Provider Demographics
NPI:1306913546
Name:MOSKIN, KATHLEEN PATRICIA (FNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:PATRICIA
Last Name:MOSKIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 POINT BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:NJ
Mailing Address - Zip Code:07421-1804
Mailing Address - Country:US
Mailing Address - Phone:973-853-7310
Mailing Address - Fax:973-853-4868
Practice Address - Street 1:301 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1544
Practice Address - Country:US
Practice Address - Phone:201-444-4526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05165000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P12110Medicare UPIN