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Individual
KIM ANN MOORE
Active
Individual
KIM ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
040519
NY
183500000X
Pharmacist
Primary
28RI02876300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040519
—
NY
Enumeration date
02/17/2008
Last updated
10/31/2013
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