Moore, Theresa A
Moore, Theresa A is an individual health care provider with primary practice located at 739 Irving Ave Suite 600, Syracuse NY 13210-1651. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Moore, Theresa A can be contacted via phone (315) 471-0190.Contact Information
Primary practice address
739 Irving Ave Suite 600
Syracuse NY 13210-1651
Phone: (315) 471-0190
Fax: (315) 471-0170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 302160 | New York |
Profile Details
| NPI number | 1982687158 |
|---|---|
| LBN Legal business name | Moore, Theresa A |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Jun 18th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982687158 | NPPES |
| New York | Other | 000923428001 | HEALTHNOW PROVIDER NUMBER |
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