Individual
DR. OLIVER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, APN, PMHNP-BC
Contact information
Practice address
550 BROAD ST STE 606, NEWARK, NJ 07102-4537
(201) 822-1161
(877) 485-8918
Mailing address
532 MARLTON PIKE W # 407, MARLTON, NJ 08053-2075
(323) 853-8019
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00872800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0813451
—
NJ
Enumeration date
10/03/2018
Last updated
07/25/2023
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