Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 15039 | NH |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 15039 | NH |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 254819 | MA |
NPI | 1487871828 |
---|---|
Provider Name | Dr. Wayne E Moschetti |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 03/09/2014 |