Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 027080 | CT |
N | 207QA0505X | Family Doctor - Adult Medicine | 027080 | CT |
NPI | 1164430070 |
---|---|
Provider Name | Dr. Lanny Moskowitz |
First Address | Torrington, CT 06790-3060 |
Second Address | Torrington, CT 06790-3060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 17/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001270800 | (05) | CT |
0100270801 | BCBS (01) | CT |
027080 | CIGNA (01) | CT |
0470889 | AETNA (01) | CT |
080000185 | MEDICARE PTAN (01) | CT |
B38324 | (02) |