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Individual
KAYLEIGH MOON
Active
Individual
KAYLEIGH MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018869
NY
363A00000X
Physician Assistant
18869
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04304674
—
NY
Enumeration date
08/11/2015
Last updated
12/01/2025
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