Individual
MATTIE D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
70 DUBOIS STREET, ST. LUKES/CORNWALL HOSPITAL, NEWBURGH, NY 12550
(845) 561-4400
(845) 938-3651
Mailing address
2 CATHARINE STREET, MID-HUDSON ANETHESIOLOGISTS, PC, POUGHKEEPSIE, NY 12602
(866) 885-2318
(845) 790-2675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
249236-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
249236-1
NY
Other
Enumeration date
03/30/2006
Last updated
10/24/2016
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