Provider Demographics
NPI:1922203777
Name:MOROSCO, MARK R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:R
Last Name:MOROSCO
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-973-7018
Practice Address - Fax:508-973-7147
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2020-04-23
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Provider Licenses
StateLicense IDTaxonomies
MA1866363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMO AP2310Medicare ID - Type Unspecified