Individual
DR. KERRY BRIGID MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
815 HALLOCK AVE, SUITE A, PORT JEFFERSON STATION, NY 11776-1220
(631) 331-7267
(631) 331-7267
Mailing address
52 ANNANDALE RD, STONY BROOK, NY 11790-2410
(631) 246-6220
(631) 246-6220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
183552
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01500581
—
NY
Enumeration date
02/06/2008
Last updated
02/06/2008
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