Basic Information
Provider Information
NPI: 1427347897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOSES
FirstName: BRETT
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 285 DAVIDSON AVE STE 204
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber:  
Practice Location
Address1: 285 DAVIDSON AVE STE 204
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2011
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X25MA09884700NJN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP3000X25MA09884700NJY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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