| Doctor Name: | BRUCE KHALIL MOORE |
| NPI Number: | 1124451257 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | EMT |
| License Number: | 2012045 |
| Business Practice Address: | 1101 Salem Ave Hillside, NJ - 072052834 |
| Business Phone Number: | 9735586942 |
| Business Fax Number: | |
| Mailing Address: | 1101 Salem Ave, HILLSIDE |
| State: | NJ |
| Postal Code: | 07120 |
| Phone Number: | 9735586942 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2013 |
| NPI Last Update Date: | 08/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 341600000X |
| License Number: | 2012045 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |