Individual
BRUCE KHALIL MOORE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
1101 SALEM AVE, HILLSIDE, NJ 07205-2834
(973) 558-6942
Mailing address
1101 SALEM AVE, HILLSIDE, NJ 07120
(973) 558-6942
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2012045
NJ
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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