Individual
MR. THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
180 BROADWAY, HICKSVILLE, NY 11801-4230
(202) 679-0909
(202) 679-0909
Mailing address
180 BROADWAY, HICKSVILLE, NY 11801-4230
(202) 679-0909
(202) 679-0909
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-59273
NY
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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