Organization
MOSS AND MAIOCCO MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID KENNETH MAIOCCO (PRACTICE ADMINISTRATOR)
(203) 374-5130
Entity
Organization
Contact information
Practice address
4639 MAIN ST, BRIDGEPORT, CT 06606-1832
(203) 374-5546
(203) 371-4056
Mailing address
4639 MAIN ST, BRIDGEPORT, CT 06606-1832
(203) 374-5546
(203) 371-4056
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4191491
—
CT
Enumeration date
04/06/2011
Last updated
02/06/2019
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