Individual
ANDREW G MOSKOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2150 MAIN ST, SPRINGFIELD, MA 01104-3566
(413) 739-5676
(413) 733-5860
Mailing address
2150 MAIN ST STE 100, SPRINGFIELD, MA 01104-3384
(860) 741-6572
(860) 253-9326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
77152
MA
208000000X
Pediatrics Physician
77152
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010077152MA01
BLUE CROSS BLUE SHIELD CT
CT
01
—
077152
TUFTS HEALTH PLAN
MA
01
—
14580
HEALTH NEW ENGLAND
MA
05
—
3113949
—
MA
01
—
J14675
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
07/17/2006
Last updated
10/22/2018
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