MEDICARE: MOZARD JEAN-NOEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	500-PA	PR

General Provider Information

NPI Number	:	1205573607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOZARD JEAN-NOEL

Provider Business Mailing Address
First Line	:	2228 BALMORAL AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5204
Country	:	US
Telephone Number	:	973-715-3961
Fax Number	:

Provider Business Practice Location Address
First Line	:	2228 BALMORAL AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5204
Country	:	US
Telephone Number	:	973-715-3961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/17/2022

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Directions to “ MOZARD JEAN-NOEL ” Practice Location

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