Moore, Kerry Brigid

Moore, Kerry Brigid is an sole proprietor health care provider with primary practice located at 815 Hallock Ave Suite A, Port Jefferson Station NY 11776-1220. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Moore, Kerry Brigid can be contacted via phone (631) 331-7267.

Contact Information

Primary practice address
815 Hallock Ave Suite A Port Jefferson Station NY 11776-1220
Phone: (631) 331-7267
Fax: (631) 331-7267
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 183552 New York

Profile Details

NPI number 1891973426
LBN Legal business name Moore, Kerry Brigid
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2008
Last updated Feb 6th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891973426 NPPES
New York MEDICAID 01500581

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