Organization
JOHN P. MOSCHELLO, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P. MOSCHELLO MD (OWNER)
(860) 274-0674
Entity
Organization
Contact information
Practice address
594 MOUNT FAIR DR, WATERTOWN, CT 06795-1661
(860) 274-0674
(860) 945-6614
Mailing address
594 MOUNT FAIR DR, WATERTOWN, CT 06795-1661
(860) 274-0674
(860) 945-6614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023988
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00123988000
BLUE CARE FAMILY PLAN
CT
01
—
010023988CT09
ANTHEM BC/BS
CT
01
—
023988
CONNECTICARE
CT
01
—
OR0625
HEALTHNET
CT
Enumeration date
06/11/2008
Last updated
07/17/2008
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