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General NPI Number Information
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NPI Number | 1205993409
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Entity Type | Individual
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Provider Name | PETER J MOLEY MD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 1 BLACHLEY ROAD
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City | STAMFORD
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State | CT
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Zip | 06902
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Country | US
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Telephone | 203-705-2120
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Fax | 646-797-8866
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Provider Business Mailing Address
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Address Line | 1 BLACHLEY ROAD
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City | STAMFORD
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State | CT
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Zip | 06902
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Country | US
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Telephone | 203-705-2349
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Fax | 646-797-8866
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 040335
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 221024
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 040335
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License Number State | CT
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