Individual
ALICIA ROSE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED
Contact information
Practice address
1150 E 93RD ST, BROOKLYN, NY 11236-3743
(347) 526-2755
Mailing address
1150 E 93RD ST, BROOKLYN, NY 11236-3743
(347) 526-2755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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