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General NPI Number Information
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NPI Number | 1245365923
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Entity Type | Organization
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Legal Business Name | FITZPATRICK MORAN COSTA & HAAG-RICKERT LLP
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 299 CAREW ST SUITE 215
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City | SPRINGFIELD
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State | MA
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Zip | 01104-2301
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Country | US
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Telephone | 413-781-6210
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Fax | 413-733-7570
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Provider Business Mailing Address
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Address Line | 299 CAREW ST SUITE 215
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City | SPRINGFIELD
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State | MA
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Zip | 01104-2301
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Country | US
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Telephone | 413-781-6210
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Fax | 413-733-7570
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Authorized Official
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Title or Position | PARTNER
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Name | DR. THOMAS J MORAN
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Credential | M.D.
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Telephone | 413-781-6210
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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 | 58798
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License Number State | MA
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