Teiah Moore, D.O.
Family Medicine in Southampton, NY. Individual provider (NPI-1).
NPI number1033520929
StatusActive
Last updated in NPPESNov 12, 2020
Details
- NPI
- 1033520929
- Entity type
- Individual (NPI-1)
- Name
- Teiah Moore
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 13, 2014
- Certification date
- Nov 12, 2020
- Last updated
- Nov 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | OS019114 | PA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
240 Meeting House LnSouthampton, NY 11968-5009
Phone 631-726-0409
Mailing address
77 Reynolds StRochester, NY 14608-2139
Phone 585-576-4649
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