Doctor Name: | MRS. LEIGH C. MOSQUERA |
NPI Number: | 1043683626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 25MP00092800 |
Business Practice Address: | 741 Northfield Ave West Orange, NJ - 070521174 |
Business Phone Number: | 9734679055 |
Business Fax Number: | 9734679586 |
Mailing Address: | 741 Northfield Ave, WEST ORANGE |
State: | NJ |
Postal Code: | 070521174 |
Phone Number: | 9734679055 |
Fax Number: | 9734679586 |
NPI Enumeration Date: | 11/04/2015 |
NPI Last Update Date: | 11/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 25MP00092800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |