Individual
JAMIE RACHEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
180 E PULASKI RD, HUNTINGTON STATION, NY 11746-1915
(631) 425-2121
Mailing address
18 WHITSON RD, HUNTINGTON STATION, NY 11746-2647
(631) 525-6487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
650434
NY
207L00000X
Anesthesiology Physician
309740
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F309740
NY
Other
Enumeration date
05/28/2020
Last updated
02/19/2026
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