Individual
MS. RENEE MOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-2420
(631) 444-7720
(631) 444-8968
Mailing address
15 VERNON LN, CENTEREACH, NY 11720-2811
(516) 607-8740
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382661
NY
Other
Enumeration date
07/11/2016
Last updated
03/23/2022
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