Provider Demographics
NPI:1114139110
Name:CHRISTOUDIAS, MOIRA KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MOIRA
Middle Name:KATHERINE
Last Name:CHRISTOUDIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MOIRA
Other - Middle Name:KATHERINE
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:BOX 152
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-4166
Practice Address - Fax:973-290-7152
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery