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General NPI Number Information
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NPI Number | 1891999652
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Entity Type | Organization
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Legal Business Name | WILLIAM J. MORAN MD,PC
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17 HENSHAW ST
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City | BRIGHTON
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State | MA
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Zip | 02135-2905
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Country | US
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Telephone | 617-782-0063
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Fax | 617-789-2126
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Provider Business Mailing Address
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Address Line | 17 HENSHAW ST
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City | BRIGHTON
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State | MA
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Zip | 02135-2905
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Country | US
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Telephone | 617-782-0063
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Fax | 617-789-2126
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM J MORAN
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Credential | M,D,
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Telephone | 617-782-0063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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