Individual
ANGELA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDN
Contact information
Practice address
256 MASON AVE, STATEN ISLAND, NY 10305
(718) 226-1300
(718) 226-1259
Mailing address
ONE EDGEWATER STREET, SUITE 723, STATEN ISLAND, NY 10305
(718) 226-1013
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006032
NY
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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