Doctor Name: | DR. PAMELA JEAN MOORE |
NPI Number: | 1285717009 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 032455 |
Business Practice Address: | 1000 Silver Street Connecticut Valley Hospital Middletown, CT - 064577023 |
Business Phone Number: | 8602936424 |
Business Fax Number: | |
Mailing Address: | Po Box 351, 1000 Silver Street MIDDLETOWN |
State: | CT |
Postal Code: | 064577023 |
Phone Number: | 8602936424 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 032455 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |