Provider Demographics
NPI:1942923842
Name:MOFFAT, ISABELLA ELENA
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ELENA
Last Name:MOFFAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8307
Mailing Address - Country:US
Mailing Address - Phone:347-971-4150
Mailing Address - Fax:
Practice Address - Street 1:1133 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8307
Practice Address - Country:US
Practice Address - Phone:347-971-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant