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Individual

MOISES MORIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1719 MAIN STREET, LAKE COMO, NJ 07719-3097
(732) 894-9200
Mailing address
1719 MAIN STREET, LAKE COMO, NJ 07719-3097
(732) 894-9200

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00054200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1649561812
GROUP NPI
NJ
01
25MZ00054200
STATE LICENSE
NJ
Enumeration date
04/11/2012
Last updated
04/11/2012
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