Provider Demographics
NPI:1700106812
Name:MOSKOWITZ, CRAIG BARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BARRY
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 JEFFERSON STREET
Mailing Address - Street 2:HARTFORD HOSPITAL CARDIOLOGY DEPT
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-972-1506
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR STREET
Practice Address - Street 2:HARTFORD HOSPITAL CARDIOLOGY DEPT
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-5037
Practice Address - Country:US
Practice Address - Phone:860-972-1506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT052013207RC0001X, 390200000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008044532Medicaid
CT3623577OtherUHC
CT010052013CT01OtherANTHEM BCBS CT
CT1186478OtherUSA
CT02499765OtherCOVENTRY/FIRST HEALTH
CT3623577OtherOXFORD
CT0201305OtherCONNECTICARE
CT4970214OtherAETNA
CTPENDINGOtherRR MEDICARE
CTD400089104Medicare PIN