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Peter Moulton

NPI 1669952032 · on the registry since 2018 · sole proprietor

Practice

Address
77 Rumford Ave
Waltham, MA 02453
Phone
(781) 894-4325
Organisation at this address
The Children'S Charter Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
77

Registry record

Primary taxonomy
390200000X
390200000X
Also registered as
101YM0800X
Licence states on file
MA, NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-09-20
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts