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NPI Code Detail

MEDICARE: DR. WOO MOON MD

MEDICARE:  DR. WOO  MOON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician25MA07436600NJ
2207R00000XInternal Medicine Physician25MA07436600NJ

Other Identifiers

General Provider Information

NPI Number : 1457345084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WOO MOON MD
Provider Business Mailing Address
First Line : 66 WEST GILBERT STREET
Second Line : SUITE 100
City : RED BANK
State : NJ
Zip : 07701-4918
Country : US
Telephone Number : 732-212-0060
Fax Number :
Provider Business Practice Location Address
First Line : 495 NORTH 13TH STREET
Second Line :
City : NEWARK
State : NJ
Zip : 07107-1397
Country : US
Telephone Number : 973-268-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 02/22/2008

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Directions to “ DR. WOO MOON MD” Practice Location

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