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General NPI Number Information
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NPI Number | 1952376543
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Entity Type | Individual
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Provider Name | CHRISTOPHER DAVID MOORE O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30 MALL DR W # 103A
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1615
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Country | US
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Telephone | 201-420-9471
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Fax | 201-420-9923
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Provider Business Mailing Address
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Address Line | 12 ELAINE CT
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City | CALIFON
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State | NJ
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Zip | 07830-3554
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Country | US
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Telephone | 201-420-9471
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Fax | 201-420-9923
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4830
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License Number State | NJ
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