Individual
MARK MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
720 HARRISON AVE, SUITE 707, BOSTON, MA 02118-2371
(617) 638-8456
(617) 638-8465
Mailing address
720 HARRISON AVE, SUITE 707, BOSTON, MA 02118-2371
(617) 638-8456
(617) 638-8465
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
3324
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516554
—
MA
Enumeration date
04/10/2006
Last updated
08/14/2007
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