Moon, H Suzanne

Moon, H Suzanne is an individual health care provider with primary practice located at 169 Libbey Industrial Pkwy 2Nd Floor, Weymouth MA 02189-3101. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Moon, H Suzanne can be contacted via phone (781) 682-1060.

Contact Information

Primary practice address
169 Libbey Industrial Pkwy 2Nd Floor Weymouth MA 02189-3101
Phone: (781) 682-1060
Fax: (781) 682-1061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 7771 Massachusetts
Behavioral Health & Social Service Providers / Health Service 103TH0100X 7771 Massachusetts

Profile Details

NPI number 1104906114
LBN Legal business name Moon, H Suzanne
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104906114 NPPES
Massachusetts Other W06212 BCBS PROVIDER NUMBER
Massachusetts MEDICAID 0502197 BCBS PROVIDER NUMBER
Massachusetts Other A866565 BCBS PROVIDER NUMBER

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