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NPI Code Detail

MEDICARE: REBECCA CHRISITANE MOORE D.O.

MEDICARE: REBECCA CHRISITANE MOORE D.O.
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
1207Q00000XFamily Medicine Physician25MB07787600NJ

Other Identifiers

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

General Provider Information

NPI Number : 1558391490
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA CHRISITANE MOORE D.O.
Provider Business Mailing Address
First Line : 854 S WHITE HORSE PIKE UNIT 4
Second Line :
City : HAMMONTON
State : NJ
Zip : 08037-2033
Country : US
Telephone Number : 609-704-0185
Fax Number : 609-704-0195
Provider Business Practice Location Address
First Line : 854 S WHITE HORSE PIKE UNIT 4
Second Line :
City : HAMMONTON
State : NJ
Zip : 08037-2033
Country : US
Telephone Number : 609-704-0185
Fax Number : 609-704-0195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 06/25/2024

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