MEDICARE: MELISSA MOSER

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
1	235Z00000X	Speech-Language Pathologist	TL-2993	NJ

General Provider Information

NPI Number	:	1588153217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MOSER

Provider Business Mailing Address
First Line	:	501 ADAMS ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-2028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18-01 POLLITT DR STE 1
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-2816
Country	:	US
Telephone Number	:	201-478-4200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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Directions to “ MELISSA MOSER ” Practice Location

Language	Start Address	Practice Location

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