Individual
KERRY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
30 CHARLTON ST STE 1, NEW YORK, NY 10014-4927
(917) 755-2992
Mailing address
115 BOYCE RD, NASSAU, NY 12123-3012
(917) 755-2992
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
001108
NY
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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