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NPI Code Detail

MEDICARE: LAUREN ELIZABETH MOORE MD

MEDICARE: LAUREN ELIZABETH MOORE MD
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
12084P0800XPsychiatry PhysicianMD474256PA

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 : 1588907125
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ELIZABETH MOORE MD
Provider Business Mailing Address
First Line : 111 ELWYN RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-4622
Country : US
Telephone Number : 610-528-4045
Fax Number :
Provider Business Practice Location Address
First Line : 111 ELWYN RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-4622
Country : US
Telephone Number : 610-891-2324
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2013
Last Update Date : 08/10/2022

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