Provider Demographics
NPI:1881707230
Name:DANIEL J. MOSCHILLO, DC
Entity type:Organization
Organization Name:DANIEL J. MOSCHILLO, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOSCHILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-347-5125
Mailing Address - Street 1:192 N BUHL FARM DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-1773
Mailing Address - Country:US
Mailing Address - Phone:724-347-5125
Mailing Address - Fax:724-923-3015
Practice Address - Street 1:192 N BUHL FARM DR
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-1773
Practice Address - Country:US
Practice Address - Phone:724-347-5125
Practice Address - Fax:724-923-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001469238OtherHIGHMARK BLUE SHIELD
PA001953053Medicaid
PA0019530530001Medicaid
PA001469951OtherHIGHMARK BLUE SHIELD IND
PA=========OtherHEALTH ASSURANCE
PAU94533Medicare UPIN
PA068191Medicare PIN