Therese Conway Moltz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.000228 Issued in OH

Practice address

2322 E 22ND St
Cleveland, OH 44115-3176

Phone

(216) 363-2691

Fax

(216) 694-4665

NPI assigned

Apr 24, 2009

Last updated

Apr 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1831333574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-363-2691",
            "fax_number": "216-694-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153176",
            "telephone_number": "216-363-2691",
            "fax_number": "216-694-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTZ",
        "first_name": "THERESE",
        "middle_name": "CONWAY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.