Healthcare Provider Details

I. General information

NPI: 1063404093
Provider Name (Legal Business Name): LANE MOSKOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CAPITAL WAY
PENNINGTON NJ
08534-2520
US

IV. Provider business mailing address

670 LAWN AVE STE 4
SELLERSVILLE PA
18960-1571
US

V. Phone/Fax

Practice location:
  • Phone: 609-303-4000
  • Fax:
Mailing address:
  • Phone: 215-257-0414
  • Fax: 215-257-1740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD061728L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25IA12906500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: