Individual
KIM ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2006 HWY 35, SPRING LAKE, NJ 07762-2543
(732) 282-0719
(732) 282-9069
Mailing address
54 OVERLOOK DR, JACKSON, NJ 08527-4849
(732) 833-7326
(732) 833-7326
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
040519
NY
183500000X
Pharmacist
Primary
28RI02876300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040519
—
NY
Enumeration date
02/17/2008
Last updated
10/31/2013
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