Individual
MR. KASEEM S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AMBULETTE DRIVER
Contact information
Practice address
25 POND HILL LN, WALDEN, NY 12586-2264
(845) 275-2632
(845) 713-4656
Mailing address
25 POND HILL LN, WALDEN, NY 12586-2264
(845) 275-2632
(845) 713-4656
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
806599263
NY
Other
Enumeration date
03/12/2020
Last updated
09/11/2025
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