Individual
LAUREN ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 ELWYN RD, MEDIA, PA 19063-4622
(610) 891-2324
Mailing address
111 ELWYN RD, MEDIA, PA 19063-4622
(610) 528-4045
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD474256
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103908891001
—
PA
Enumeration date
04/02/2013
Last updated
08/10/2022
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