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Individual

DR. SANDRA LEIGH MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
301 E 17TH ST, NEW YORK, NY 10003-3804
(212) 263-0050
Mailing address
3213 34TH ST, APT. 2R, ASTORIA, NY 11106-1844

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
195913
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06237630
NY
Enumeration date
04/21/2006
Last updated
08/08/2011
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