Provider Demographics
NPI:1750279121
Name:MOSCA, JOHN ANTHONY JR (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:MOSCA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1587
Mailing Address - Country:US
Mailing Address - Phone:973-713-4268
Mailing Address - Fax:
Practice Address - Street 1:51 MINE HILL RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1587
Practice Address - Country:US
Practice Address - Phone:973-713-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3770338171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach