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1770785040 NPI number — EVERETT MOITOZA ED.D, MBA

NPI Number: 1770785040
Health Care Provider/Practitioner: EVERETT MOITOZA ED.D, MBA

Information about “1770785040” NPI (EVERETT MOITOZA ED.D, MBA) exists in 1770785040 in HTML format HTML  |  1770785040 in plain Text format TXT  |  1770785040 in PDF (Portable Document Format) PDF  |  1770785040 in an XML format XML  formats.

NPI Number : 1770785040 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770785040",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOITOZA",
    "FirstName": "EVERETT",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "ED.D, MBA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 560",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RYE",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03870-0560",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-964-2111",
    "MailingAddressFaxNumber": "603-964-2111",
    "FirstLinePracticeLocationAddress": "390 CENTRAL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RYE",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03870-2526",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-964-2111",
    "PracticeLocationAddressFaxNumber": "603-964-2111",
    "EnumerationDate": "05/31/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103T00000X",
        "TaxonomyName": "Psychologist",
        "LicenseNumber": "293",
        "LicenseNumberStateCode": "NH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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