Individual
MS. BRIDGET MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2171 JERICHO TPKE STE LL2, COMMACK, NY 11725-2900
(516) 817-6002
Mailing address
2171 JERICHO TPKE, COMMACK, NY 11725-2937
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111206
NY
Other
Enumeration date
04/05/2022
Last updated
04/16/2022
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