Individual
ALYSSA N MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
412 STATE ROUTE 37, HOGANSBURG, NY 13655-3109
(518) 358-3141
Mailing address
4 HAMILTON ST, APT 3, POTSDAM, NY 13676-2049
(518) 669-2969
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017600
NY
363A00000X
Physician Assistant
P92874
NY
Other
Enumeration date
06/02/2014
Last updated
06/19/2014
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