Individual
THOMAS E. MOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
200 CANAL VIEW BLVD, SUITE 102, ROCHESTER, NY 14623-2852
(585) 461-5330
(585) 461-9895
Mailing address
12 CHELSEA WAY, FAIRPORT, NY 14450-3215
(585) 425-3245
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006431
NY
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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