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General NPI Number Information
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NPI Number | 1871159848
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Entity Type | Individual
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Provider Name | ANDREW S MOON MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 54 HOPEDALE ST STE 3
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City | HOPEDALE
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State | MA
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Zip | 01747-1719
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Country | US
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Telephone | 617-431-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HAY RD
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City | NEWTON
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State | MA
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Zip | 02459-3609
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Country | US
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Telephone | 978-201-2568
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Fax |
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 1022837
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A195409
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License Number State | CA
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