Tracking Details - #1251

Tracking Information
Case No: 1117
Order Date: 12/12/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: Abram Mozes, MD
496 Smithtown Bypass, Suite 101
Smithtown, NY 11787
Phone: (631) 784-7370 • Fax: (631) 784-7379
Patient: Rihanna Fenty
DOB: 07/15/1950 • SSN: ***-**-8376
Abram Mozes, MD
496 Smithtown Bypass, Suite 101
Smithtown, NY 11787
Phone: (631) 784-7370 • Fax: (631) 784-7379
Recommended for this case: New York HIPAA Authorization Packet via PacketTemplateDefault (LegacyDefault).
Rihanna Fenty
DOB: 07/15/1950 • SSN: ***-**-8376
Requested Records
Record Status
Medical Fulfilled
File Name Uploaded Date Uploaded By
WebPage (1)_20251212004711534.pdf 2025-12-12
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 12/11/2025 7:47 PM
Generation Dept - Printed Packet 12/12/2025 Yes 12/12/2025 12:47 AM
Fax sent 2/8/2026 No 2/8/2026 5:49 PM
Fax delivery confirmed 2/8/2026 Fax delivered (manual) No 2/8/2026 5:50 PM
Assigned To: 2/10/2026 Assigned To: UserNo=1005 [INITIAL] No 2/8/2026 5:50 PM
Received - All Records Received - Records Yes 3/3/2026 3:01 AM
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