Provider Demographics
NPI:1962502427
Name:MOSS, ALAN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PAUL
Last Name:MOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:479 OLD UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-3029
Mailing Address - Country:US
Mailing Address - Phone:978-537-3900
Mailing Address - Fax:978-537-6030
Practice Address - Street 1:255 PARK AVE
Practice Address - Street 2:SUITE 606
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1988
Practice Address - Country:US
Practice Address - Phone:508-753-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42575207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9716475Medicaid
MA9716475Medicaid
M12928Medicare ID - Type Unspecified