National Provider Identifier
Jack P Moss, RN
Jack P Moss, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Ithaca, NY and a listed phone number of (607) 274-6604.
Profile Overview
- NPI
- 1689982530
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- September 14, 2010
- Last Updated
- September 14, 2010
Practice Location
- 55 Brown RD
- Ithaca, NY 14850-1247
Phone: (607) 274-6604
Specialties
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1689982530
- Entity Type
- Individual
- Last Name
- Moss
- First Name
- Jack
- Middle Name
- P
- Credential
- RN
- Mailing Street Address
- 55 Brown RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1247
- Mailing Country
- US
- Mailing Phone
- (607) 274-6604
- Mailing Fax
- (607) 274-6620
- Practice Street Address
- 55 Brown RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1247
- Practice Country
- US
- Practice Phone
- (607) 274-6604
- Practice Fax
- (607) 274-6620
- Enumeration Date
- September 14, 2010
- Last Updated
- September 14, 2010
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X)
- Other Identifiers
- 22 439954 (NY, Nursing License)