Provider Demographics
NPI:1689649030
Name:MOSKOWITZ, RICHARD LEE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MADISON AVE
Mailing Address - Street 2:STE 312
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-267-1225
Mailing Address - Fax:973-993-9190
Practice Address - Street 1:111 MADISON AVE
Practice Address - Street 2:STE 312
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-267-1225
Practice Address - Fax:973-993-9190
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04768700208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0200105000OtherAMERIHEALTH
IS107OtherOXFORD
455750OtherAETNA
NJ141199Medicare ID - Type Unspecified
0200105000OtherAMERIHEALTH