5 CRYSTAL LANE, BRENTWOOD, 11717, NEW YORK
| Entity Name | IDEL MOISA, M.D., P.C. |
| Entity Number | 4612036 |
| Status | ACTIVE |
| Incorporation Date | 25th July 2014 |
| Dos Process Address | 666 OLD COUNTRY ROAD, GARDEN CITY, 11530, NEW YORK |
| Jurisdiction | NEW YORK |
| County | NASSAU |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |