Provider Demographics
NPI:1417098187
Name:MOSKEWICZ, LORRAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:MOSKEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 HUDSON RD PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-0616
Mailing Address - Country:US
Mailing Address - Phone:410-228-3100
Mailing Address - Fax:
Practice Address - Street 1:1743 HUDSON RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3348
Practice Address - Country:US
Practice Address - Phone:410-228-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01093103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist