Individual
NICHOLAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-9770
(212) 305-5848
Mailing address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-9770
(212) 305-5848
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
323077
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
06/14/2023
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