Individual
PAMELA A. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 ROYCE CIR, SUITE 104, STORRS, CT 06268-2260
(860) 487-9200
(860) 487-9222
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
032427
CT
207Q00000X
Family Medicine Physician
Primary
032427
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00030315
RAILROAD
—
Enumeration date
02/16/2006
Last updated
09/28/2022
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