Active NPI
Peterson Moise, MD
- Occupational Medicine Physician
- Willingboro, NJ
National Provider Identifier
1811526593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- NJDCATEMP-000600
- Practice address
- 54 Ember LN
Willingboro, NJ 08046-2422 - Phone
- (786) 362-4898
- NPI assigned
- Apr 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | NJDCATEMP-000600 | NJ | Primary |
Addresses
Primary practice location
54 Ember LN
Willingboro, NJ 08046-2422
Mailing address
54 Ember LN
Willingboro, NJ 08046-2422
Phone (786) 362-4898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJDCATEMP-000600 | NJ | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586044800000",
"number": "1811526593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 EMBER LN",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080462422",
"telephone_number": "786-362-4898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 EMBER LN",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080462422",
"telephone_number": "786-362-4898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOISE",
"first_name": "PETERSON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-05",
"last_updated": "2020-04-05",
"certification_date": "2020-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NJ",
"license": "NJDCATEMP-000600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willingboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.