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Individual

RICHARD DOMINICK MORO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
558 NORWICH RD, PLAINFIELD, CT 06374-1725
(608) 564-4054
(608) 564-0354
Mailing address
558 NORWICH RD, PLAINFIELD, CT 06374-1725
(608) 564-4054
(608) 564-0354

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001890
CT
363A00000X
Physician Assistant
004547-1
NY
363A00000X
Physician Assistant
104122
NC
363AM0700X
Medical Physician Assistant
001890
CT

Other

Enumeration date
02/08/2006
Last updated
05/27/2022
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