Moore, Gregg A.
Moore, Gregg A. is an sole proprietor health care provider with primary practice located at 60 Oswego St Ste 1 , Baldwinsville NY 13027-2446. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Moore, Gregg A. can be contacted via phone (315) 415-9795.Contact Information
Primary practice address
60 Oswego St Ste 1
Baldwinsville NY 13027-2446
Phone: (315) 415-9795
Fax: (315) 415-9795
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R070522 | New York |
Profile Details
| NPI number | 1396854030 |
|---|---|
| LBN Legal business name | Moore, Gregg A. |
| Credentials | LCSW-R |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Apr 16th, 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 | 1396854030 | NPPES |
| New York | MEDICAID | 01649605 |
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