| Doctor Name: | MRS. KAYLEEN M MOORE |
| NPI Number: | 1073940615 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA4835 |
| Business Practice Address: | 100 Highland St Suite 300 Milton, MA - 021863881 |
| Business Phone Number: | 6176988855 |
| Business Fax Number: | |
| Mailing Address: | 100 Highland St, Suite 300 MILTON |
| State: | MA |
| Postal Code: | 021863881 |
| Phone Number: | 6176988855 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2013 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA4835 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |