Moore, Gregory
Moore, Gregory is an individual health care provider with primary practice located at 9729 64Th Rd , Rego Park NY 11374-2240. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Moore, Gregory can be contacted via phone (718) 896-3400.Contact Information
Primary practice address
9729 64Th Rd
Rego Park NY 11374-2240
Phone: (718) 896-3400
Fax: (718) 459-5621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 17304 | New York |
Profile Details
| NPI number | 1750558920 |
|---|---|
| LBN Legal business name | Moore, Gregory |
| Credentials | CASAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2008 |
| Last updated | May 15th, 2008 - about 17 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 | 1750558920 | NPPES |
| New York | MEDICAID | 00244019 |
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