Individual
DR. GEOFFREY E. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 624-1914
(315) 624-1917
Mailing address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 624-1914
(315) 624-1917
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
227508-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000076465
GHI HMO
NY
01
—
000927628002
HEALTHNOW
NY
01
—
10077558
CDPHP
NY
01
—
2592101
GHI PPO & CMP
NY
01
—
363245
MVP
NY
Enumeration date
09/23/2006
Last updated
07/08/2007
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