Provider Demographics
NPI:1295816551
Name:MOSKOWITZ, SAMUEL M (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:M
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:175 CAMBRIDGE ST., CPZS-556
Mailing Address - Street 2:DIVISION OF PEDIATRIC PULMONARY MEDICINE, MGH
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-643-7232
Mailing Address - Fax:617-643-7234
Practice Address - Street 1:175 CAMBRIDGE STREET, CPZS-556
Practice Address - Street 2:DIVISION OF PEDIATRIC PULMONARY MEDICINE, MGH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-643-7232
Practice Address - Fax:617-643-7234
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-08-18
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Provider Licenses
StateLicense IDTaxonomies
WAMD000353682080P0214X
MA2366162080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3209OtherINTERNAL ID-MOTOR VEHICLE ID
WA8270696Medicaid
WA8270696Medicaid
3209OtherINTERNAL ID-MOTOR VEHICLE ID