Organization
STAVROULA MOSHOS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STAVROULA MOSHOS O.D. (PRESIDENT)
(732) 991-4936
Entity
Organization
Contact information
Practice address
979 ROUTE 1 SOUTH, NORTH BRUNSWICK, NJ 08902
(732) 991-4936
Mailing address
5 GRACE RD, EAST BRUNSWICK, NJ 08816-2753
(732) 991-4936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00603000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102270
—
NJ
05
—
02751779
—
NY
01
—
1255384152
NPI # UNDER INDIVIDUAL
NJ
Enumeration date
06/12/2007
Last updated
04/04/2011
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