Individual provider · Type 1 NPI

Moira Jane Carroll

Surgical Physician Assistant · Philadelphia, PA

NPI number 1760386478 Active

Practice location

1 Convention Ave
Philadelphia, PA 19104-4311

Call (215) 662-4004 Map

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XMA068269 (PA)

Surgical Physician Assistant: Definition to come...

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About NPI 1760386478

Moira Jane Carroll's National Provider Identifier is 1760386478, issued on Oct 6, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Philadelphia, PA. The record was last updated on Oct 6, 2026.