Provider Demographics
NPI:1114035466
Name:MOYSE, JOSEPH G
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:MOYSE
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:G
Other - Last Name:MOYSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2987
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2987
Mailing Address - Country:US
Mailing Address - Phone:787-785-6211
Mailing Address - Fax:787-780-0898
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 706
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-6211
Practice Address - Fax:787-780-0898
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM15224174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist