Individual
REBECCA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC CARDIOLOGY, PHILADELPHIA, PA 19104
(215) 327-2667
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC CARDIOLOGY, PHILADELPHIA, PA 19104
(215) 327-2667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP03975
RI
208000000X
Pediatrics Physician
LP03975
RI
2080P0202X
Pediatric Cardiology Physician
Primary
MT222536
PA
Other
Enumeration date
06/15/2017
Last updated
07/13/2021
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