Individual
DAVAUGHN MOORER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1419 SHAKESPEARE AVE APT 3C, BRONX, NY 10452-1854
(347) 802-5361
Mailing address
1419 SHAKESPEARE AVE APT 3C, BRONX, NY 10452-1854
(347) 802-5361
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
582950435
NY
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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