Individual
ANDRE ANTHONY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
160 BLEECKER ST, 9 C EAST, NEW YORK, NY 10012-1541
(212) 673-4618
Mailing address
160 BLEECKER STREET, 9 C EAST, NEW YORK, NY 10012
(212) 673-4618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R016091P
NY
101Y00000X
Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P2128967
UNITED HEALTH CARE - OXFORD
NY
Enumeration date
05/23/2013
Last updated
05/23/2013
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