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MR. GERALD MICHAEL MOSCHGAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
617 MAIN ST, PORTAGE, PA 15946-1569
(814) 736-4351
(814) 736-9522
Mailing address
617 MAIN ST, PORTAGE, PA 15946-1569
(814) 736-4351
(814) 736-9522

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP030746L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PP481858
PA STATE LICENSE #
PA
Enumeration date
12/09/2009
Last updated
12/09/2009
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