Moore, Stephanie Polk
Moore, Stephanie Polk is an sole proprietor health care provider with primary practice located at 159 Margaret St Suite 100, Plattsburgh NY 12901-1874. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Moore, Stephanie Polk can be contacted via phone (518) 324-2040.Contact Information
Primary practice address
159 Margaret St Suite 100
Plattsburgh NY 12901-1874
Phone: (518) 324-2040
Fax: (518) 324-2041
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 224178-1 | New York |
Profile Details
| NPI number | 1902955149 |
|---|---|
| LBN Legal business name | Moore, Stephanie Polk |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Jul 9th, 2007 - 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 | 1902955149 | NPPES |
| New York | MEDICAID | 02743295 |
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