Individual
MR. SAM EUGENE MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AMBULETTE
Contact information
Practice address
33 DU BOIS AVE, POUGHKEEPSIE, NY 12601-2140
(845) 464-4162
Mailing address
33 DU BOIS AVE, POUGHKEEPSIE, NY 12601-2140
(845) 464-4162
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
5363887522
NY
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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