| Daniel Moore, PSYD | |
|
10 Gove St, East Boston, MA 02128-1920 | |
| (617) 569-5800 | |
| Not Available |
| Full Name | Daniel Moore |
|---|---|
| Gender | Male |
| Speciality | Psychologist |
| Location | 10 Gove St, East Boston, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730660630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 11970 (Massachusetts) | Primary |
| Entity Name | Internal Medical Associates-ebnhc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558481879 PECOS PAC ID: 6103814371 Enrollment ID: O20040505000853 |
| Entity Name | East Boston Neighborhood Health Center Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316994411 PECOS PAC ID: 9032356050 Enrollment ID: O20130513000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Moore, PSYD 10 Gove St, East Boston, MA 02128-1920 Ph: (617) 569-5800 | Daniel Moore, PSYD 10 Gove St, East Boston, MA 02128-1920 Ph: (617) 569-5800 |
John Joseph Janko, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 14 Porter St, East Boston, MA 02128 Phone: 617-569-3189 Fax: 617-569-7890 | |
Felix Trede, Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-568-5800 Fax: 617-568-4756 | |
Emily M. Stoddard, MA, EDS Psychologist Medicare: Not Enrolled in Medicare Practice Location: 122 Cottage St, East Boston, MA 02128 Phone: 617-635-8510 | |
Elizabeth Lane Shum, PSY.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4756 |