Provider Demographics
NPI:1922048453
Name:MOSCHITTO, LAWRENCE J (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:J
Last Name:MOSCHITTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ROWE ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3201
Mailing Address - Country:US
Mailing Address - Phone:781-979-3440
Mailing Address - Fax:
Practice Address - Street 1:50 ROWE ST STE 600
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3201
Practice Address - Country:US
Practice Address - Phone:781-979-3440
Practice Address - Fax:781-979-0258
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA52256207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease