Individual
NICOLE PATRICIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
Mailing address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
695945
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
432399
NY
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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