Provider Information for 1881011823
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Dr. NATALIE JEANNE MOORE MD
Sex: Female
NPI: 1881011823
Last Updated: 2022-07-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1881011823 | ||||||||||||
| Enumeration Date | 2014-03-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 263 FARMINGTON AVENUE FARMINGTON, CT 06030-0001 United States Phone: 860-679-2000 | Fax: | ||||||||||||
| Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-1001 United States Phone: 860-679-2147 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 759 CHESTNUT ST | ||||||||||||
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