Provider Demographics
NPI:1972578532
Name:MOY, ANNA (DPM)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:MOY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3619
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07303-3619
Mailing Address - Country:US
Mailing Address - Phone:201-938-1866
Mailing Address - Fax:973-416-0179
Practice Address - Street 1:633 NYE AVE
Practice Address - Street 2:STE A7
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111
Practice Address - Country:US
Practice Address - Phone:973-416-1333
Practice Address - Fax:973-416-0179
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD00155900213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0313301Medicaid
440798Medicare ID - Type Unspecified
T44969Medicare UPIN