MEDICARE: DR. MICHAEL THOMAS MOSKO PSY.D.

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	103TC0700X	Clinical Psychologist	PS016152	PA

General Provider Information

NPI Number	:	1942316393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL THOMAS MOSKO PSY.D.

Provider Business Mailing Address
First Line	:	100 S 7TH AVE
Second Line	:
City	:	WEST READING
State	:	PA
Zip	:	19611-1022
Country	:	US
Telephone Number	:	610-413-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	938 PENN AVE
Second Line	:
City	:	WYOMISSING
State	:	PA
Zip	:	19610-3017
Country	:	US
Telephone Number	:	610-372-0466
Fax Number	:

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	05/20/2008

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