Individual
CATHERINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-3362
Mailing address
24 WESTBROOK LN, ROOSEVELT, NY 11575-1016
(516) 623-3362
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
236735-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236735-1
LICENSE
NY
Enumeration date
03/14/2007
Last updated
07/08/2007
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