Justin Moazzami, PHARMD
Individual provider Active NPI Pharmacist · Harwich, MA
NPI 1649049164 · NPPES record last updated Dec 26, 2023
Key facts
- NPI
- 1649049164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH997179 (MA)
- Practice address
- 148 Route 137
Harwich, MA 02645-1316 - Phone
- (508) 432-2018
- NPI assigned
- Dec 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH997179 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH997179 | MA | Yes |
Addresses
Primary practice location
148 Route 137
Harwich, MA 02645-1316
Mailing address
148 Route 137
Harwich, MA 02645-1316
Other providers in Harwich, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.