Provider Demographics
NPI:1760809503
Name:MOSCARELLI, RHIANNON E (IDC)
Entity Type:Individual
Prefix:MRS
First Name:RHIANNON
Middle Name:E
Last Name:MOSCARELLI
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS ABRAHAM LINCOLN (CVN 72)
Mailing Address - Street 2:UNIT 100349 BOX 1
Mailing Address - City:FPO AE
Mailing Address - State:VA
Mailing Address - Zip Code:09520-2872
Mailing Address - Country:US
Mailing Address - Phone:757-534-0097
Mailing Address - Fax:
Practice Address - Street 1:USS ABRAHAM LINCOLN (CVN 72)
Practice Address - Street 2:UNIT 100349 BOX 1
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09520-2872
Practice Address - Country:US
Practice Address - Phone:757-534-0097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
Provider Identifiers
StateIdentifier IDID TypeIssuer
1249666358OtherDOD ID