Moulton, Thomas A

Moulton, Thomas A is an individual health care provider with primary practice located at 2432 Grand Concourse Poe Clinic, Bronx NY 10458. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Moulton, Thomas A can be contacted via phone (718) 579-7337.

Contact Information

Primary practice address
2432 Grand Concourse Poe Clinic Bronx NY 10458
Phone: (718) 579-7337
Fax: (718) 817-7904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 168593 New York

Profile Details

NPI number 1215013156
LBN Legal business name Moulton, Thomas A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Mar 30th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215013156 NPPES
New York MEDICAID 01232099

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