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General NPI Number Information
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NPI Number | 1033206669
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Entity Type | Organization
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Legal Business Name | MARIO F MORETTI MD PC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12 TATUM RD
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City | SHREWSBURY
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State | MA
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Zip | 01545-3751
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Country | US
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Telephone | 508-757-4135
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Fax | 508-865-1109
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Provider Business Mailing Address
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Address Line | 12 TATUM RD
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City | SHREWSBURY
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State | MA
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Zip | 01545-3751
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Country | US
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Telephone | 508-757-4135
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Fax | 508-865-1109
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Authorized Official
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Title or Position | OWNER
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Name | MARIO F. MORETTI
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Credential | MD
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Telephone | 508-757-4135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 27540
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License Number State | MA
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