Healthcare Provider Details

I. General information

NPI: 1477151561
Provider Name (Legal Business Name): EMMA MEORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 RAYMOND AVE BOX 750
POUGHKEEPSIE NY
12604-4622
US

IV. Provider business mailing address

34 MAPLE BROOK RD
TUXEDO PARK NY
10987-4622
US

V. Phone/Fax

Practice location:
  • Phone: 845-437-7735
  • Fax:
Mailing address:
  • Phone: 845-642-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number004347-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: