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General NPI Number Information
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NPI Number | 1174414882
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND RADIOLOGICAL CONSORTIUM, LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 998 OCEAN BLVD
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City | HAMPTON
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State | NH
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Zip | 03842-1429
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Country | US
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Telephone | 757-672-0297
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Fax |
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Provider Business Mailing Address
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Address Line | 998 OCEAN BLVD
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City | HAMPTON
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State | NH
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Zip | 03842-1429
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Country | US
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Telephone | 757-672-0297
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Fax |
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Authorized Official
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Title or Position | OWNER, AUTHORIZED OFFICIAL
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Name | MATTHEW DOUGLAS MOORE SR.
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Credential | MD
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Telephone | 757-672-0297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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