MRS. Nicole Moore

NPI #1184986937 in Plainview, New York

Provider Information

NPI Number: 1184986937
Entity Type: Individual
Name: MRS. Nicole Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 7, 2012
Last Updated: Jan 24, 2016

Practice Location

Address: 255 EXECUTIVE DR
Address 2: SUITE LL 105/108
City: Plainview
State: New York
ZIP Code: 11803-1718
Phone: (516) 576-2040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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