Healthcare Provider Details

I. General information

NPI: 1144550245
Provider Name (Legal Business Name): JOSEPHINE MOYO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ABIGAIL LN
PORT MATILDA PA
16870-7153
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 814-272-5011
  • Fax: 814-272-6531
Mailing address:
  • Phone: 814-272-5011
  • Fax: 814-272-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD485552
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD485552
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: