Doctor Name: | DR. DONALD E MOORE |
NPI Number: | 1417050683 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 157236 |
Business Practice Address: | 41 Eastern Pkwy Suite 1b Brooklyn, NY - 112385934 |
Business Phone Number: | 7186222042 |
Business Fax Number: | 7186222779 |
Mailing Address: | 41 Eastern Pkwy, Suite 1b BROOKLYN |
State: | NY |
Postal Code: | 112385934 |
Phone Number: | 7186222042 |
Fax Number: | 7186222779 |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 07/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 157236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |