Individual
DR. CASEY NILSEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4363
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
296751-1
NY
Other
Enumeration date
05/01/2017
Last updated
10/17/2019
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