Individual
DOMINICK PETER MOFFRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
65 BRINKER DR, RO #1, RENSSELAER, NY 12144
(518) 286-3004
Mailing address
65 BRINKER DR, RO #1, RENSSELAER, NY 12144
(518) 286-3004
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
098837-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00347888
—
NY
Enumeration date
11/30/2006
Last updated
07/08/2007
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