Moore, Brooke Carol
Moore, Brooke Carol is an individual health care provider with primary practice located at 2500 Route 347 Bldg 14A, Stony Brook NY 11790-2554. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Moore, Brooke Carol can be contacted via phone (631) 689-7800.Contact Information
Primary practice address
2500 Route 347 Bldg 14A
Stony Brook NY 11790-2554
Phone: (631) 689-7800
Fax: (631) 689-3016
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 161222 | New York |
Profile Details
| NPI number | 1205833704 |
|---|---|
| LBN Legal business name | Moore, Brooke Carol |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Sep 20th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205833704 | NPPES |
| New York | Other | CS629 | OXFORD |
| New York | Other | 0C3233 | OXFORD |
| New York | MEDICAID | 01130890 | OXFORD |
| New York | Other | 390001418 | OXFORD |
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