Individual
MR. GEORGE V MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 MEADOW LN, CANTERBURY, CT 06331-1821
(860) 305-2083
Mailing address
890 LONG HILL RD, MIDDLETOWN, CT 06457-5063
(860) 347-9911
(860) 347-6413
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
001602
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061038160
CHAMPUS TRICARE
—
01
—
140001602CT02
BCBS
CT
01
—
2195892
CIGNA
—
01
—
254506
MHN
—
01
—
4397705
AETNA
CT
01
—
512845
VALUE OPTIONS
—
01
—
722242000
UBH
—
01
—
P3192844
OXFORD
—
Enumeration date
06/27/2006
Last updated
06/03/2025
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