Healthcare Provider Details

I. General information

NPI: 1992353080
Provider Name (Legal Business Name): MORIARTY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2019
Last Update Date: 08/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 BALTIMORE BLVD STE C
WESTMINSTER MD
21157-7144
US

IV. Provider business mailing address

PO BOX 973
WESTMINSTER MD
21158-0973
US

V. Phone/Fax

Practice location:
  • Phone: 443-388-2300
  • Fax:
Mailing address:
  • Phone: 410-848-5785
  • Fax: 410-848-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN MORIARTY
Title or Position: PROVIDER
Credential: CRNP
Phone: 443-388-2300