Healthcare Provider Details

I. General information

NPI: 1700106812
Provider Name (Legal Business Name): CRAIG BARRY MOSKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 11/27/2022
Certification Date: 11/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR STREET HARTFORD HOSPITAL CARDIOLOGY DEPT
HARTFORD CT
06102-5037
US

IV. Provider business mailing address

85 JEFFERSON STREET HARTFORD HOSPITAL CARDIOLOGY DEPT
HARTFORD CT
06106
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-1506
  • Fax:
Mailing address:
  • Phone: 860-972-1506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number052013
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: