# MICHAEL MOORE, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376738377
- **Authorized official:** DR. MICHAEL G MOORE (OWNER)
- **Authorized official phone:** (201) 689-0110

## Contact information

- **Practice address:** 171 FRANKLIN TPKE, SUITE 200, WALDWICK, NJ 07463-1849
- **Practice address phone:** (201) 689-0110
- **Practice address fax:** (201) 689-0114
- **Mailing address:** 171 FRANKLIN TPKE, SUITE 200, WALDWICK, NJ 07463-1849
- **Mailing address phone:** (201) 689-0110
- **Mailing address fax:** (201) 689-0114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | MA58638 | NJ | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |

## Other

- **Enumeration date:** 09/12/2007
- **Last updated:** 05/10/2012