Moynihan, Gavan David
Moynihan, Gavan David is an individual health care provider with primary practice located at 332 E Main St , Bay Shore NY 11706-8404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Moynihan, Gavan David can be contacted via phone (631) 666-0500.Contact Information
Primary practice address
332 E Main St
Bay Shore NY 11706-8404
Phone: (631) 666-0500
Fax: (631) 666-0503
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 122511 | New York |
Profile Details
| NPI number | 1700846797 |
|---|---|
| LBN Legal business name | Moynihan, Gavan David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Sep 16th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700846797 | NPPES |
| New York | MEDICAID | 00627990 |
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