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Individual

MICHELLE MOCCIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
125 PATERSON ST, SUITE 6100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-7733
(732) 235-7041
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NN10383100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8612609
NJ
01
P00755078
RR MCR PTAN
NJ
Enumeration date
11/22/2006
Last updated
11/17/2009
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