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General NPI Number Information
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NPI Number | 1629549936
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Entity Type | Individual
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Provider Name | SARAH MCARDELL MOORE PHD
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Gender | Female
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Dates
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Enumeration Date | 12/13/2018
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 121 E 60TH ST APT 6E
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City | NEW YORK
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State | NY
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Zip | 10022-1198
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Country | US
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Telephone | 212-879-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 2119 23RD TER # 2
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City | ASTORIA
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State | NY
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Zip | 11105-3425
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Country | US
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Telephone | 698-515-9069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 022530-1
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License Number State | NY
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