Moss and Maiocco MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MOSS AND MAIOCCO MD LLC

Practice address

4639 Main St
Bridgeport, CT 06606-1832

Phone

(203) 374-5546

Fax

(203) 371-4056

NPI assigned

Apr 6, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Kenneth Maiocco

Title

Practice Administrator

Phone

(203) 374-5130

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1013206481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4639 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061832",
            "telephone_number": "203-374-5546",
            "fax_number": "203-371-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4639 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061832",
            "telephone_number": "203-374-5546",
            "fax_number": "203-371-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSS AND MAIOCCO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "MAIOCCO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "203-374-5130",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4191491",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corinne Morrison, PA-C
• Dawn Elaine Moser, PA-C
• Ashley Moskal
• Joyce Marie Mosley, LCSW
• Melissa Nicole Mosley, MD
• Motion Rehab at Home Physical Therapy PLLC
• Fatima Bilal Motiwala, MD
• Carissa M Mott, LPC
• Sarah Motta, LCSW
• Salsabila Mouiz, M.D

• Dermatology Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.