Organization
PEDIATRICE CENTER FOR DEVELOPMENTAL EXCELLENCE, LLC
Active
Other names
Pediatric Building Blocks
Organization subpart
No
Provider details
NPI number
Authorized official
TREVENA MOORE MD (MEMBER)
(617) 306-2065
Entity
Organization
Contact information
Practice address
79 ESTATE PETER'S REST, SUITE 3.2, CHRISTIANSTED, VI 00820
(340) 473-7225
Mailing address
PO BOX 159, CHRISTIANSTED, VI 00821-0159
(340) 473-7225
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2351041B
VI
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
1229
VI
Other
Enumeration date
09/01/2016
Last updated
09/12/2016
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