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Carol Moog

NPI Registration Record

Provider / OrganizationNPIDate Certified
CAROL MOOG17408998302020-07-24
Entity TypeIndividual
Provider Name Carol Moog PHD
Practice Office Address301 KENT RD
BALA CYNWYD, PA US
Practice Office Telephone6106671540
Mailing Address301 KENT RD
BALA CYNWYD, PA 190042823 US
Business Telephone6106671540
HPT Codes
CodeLicense NoState
103T00000X PRIMARYPS002604L PA
103T00000XPS002694L PA
103TC0700XPS002604L PA
103TC1900XPS002604L PA
OPI Codes

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