National Provider Identifier
Ethan Moskovic, DDS
Ethan Moskovic, DDS is listed in the NPPES registry with a primary specialty of Dentist in Ithaca, NY and a listed phone number of (607) 273-3000.
Profile Overview
- NPI
- 1720570377
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- May 30, 2018
- Last Updated
- December 11, 2019
Practice Location
- 324 Elmira RD Ste 200
- Ithaca, NY 14850-5106
Phone: (607) 273-3000
Mailing Address
- 73 Muriel Ave
- Lawrence, NY 11559-1810
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1720570377
- Entity Type
- Individual
- Last Name
- Moskovic
- First Name
- Ethan
- Name Prefix
- Dr.
- Credential
- DDS
- Mailing Street Address
- 73 Muriel Ave
- Mailing City
- Lawrence
- Mailing State
- NY
- Mailing ZIP Code
- 11559-1810
- Mailing Country
- US
- Mailing Phone
- (516) 660-6367
- Practice Street Address
- 324 Elmira RD Ste 200
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5106
- Practice Country
- US
- Practice Phone
- (607) 273-3000
- Enumeration Date
- May 30, 2018
- Last Updated
- December 11, 2019
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 11, 2019
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)