John P. Moschello, MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

023988 Issued in CT

Legal business name

JOHN P. MOSCHELLO, MD, PC

Practice address

594 Mount Fair Dr
Watertown, CT 06795-1661

Phone

(860) 274-0674

Fax

(860) 945-6614

NPI assigned

Jun 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John P. Moschello, MD

Title

Owner

Phone

(860) 274-0674

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1700046083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 MOUNT FAIR DR",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951661",
            "telephone_number": "860-274-0674",
            "fax_number": "860-945-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 MOUNT FAIR DR",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951661",
            "telephone_number": "860-274-0674",
            "fax_number": "860-945-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P. MOSCHELLO, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "MOSCHELLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-274-0674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "023988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN",
            "identifier": "00123988000",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OR0625",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010023988CT09",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "023988",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donn Anthony Innaimo, D.C.
• Iris Behavioral Health Services LLC
• Sara Jalbert, LPC, LP
• Aimee Jette, LPC, ATR
• Ellen L Jobin, B.S.H.I.S.
• Rebecca Juliano, MSPT
• Brynn Kallstrom
• Kimberly Keegan
• Megan K Kellogg, MA, MT-BC
• Kyle Brian Kemp, DPT

• Internal Medicine Physician in Watertown, CT
• Providers in Watertown, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.