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NPI Code Detail

MEDICARE: MRS. CYNTHIA L MOORE NP

MEDICARE: MRS. CYNTHIA L MOORE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner200257MA
2363L00000XNurse PractitionerRN200257MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP3279OTHERMABLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346209897
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA L MOORE NP
Provider Business Mailing Address
First Line : 3 WYMAN ST
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-4728
Country : US
Telephone Number : 781-258-5717
Fax Number :
Provider Business Practice Location Address
First Line : 269 UNION ST
Second Line :
City : LYNN
State : MA
Zip : 01901-1314
Country : US
Telephone Number : 781-599-3925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 09/27/2013

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