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:
Health care specialties
Specialty | Code | License # | 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 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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