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Ivy Maria Moore, RN

Registered Nurse in Albany, NY. Individual provider (NPI-1).

NPI number1801366166
StatusActive
Last updated in NPPESNov 29, 2018

Details

NPI
1801366166
Entity type
Individual (NPI-1)
Name
Ms. Ivy Maria Moore
Credential
RN
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 29, 2018
Last updated
Nov 29, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163W00000X Registered Nurse525578NYYes

Practice location

90 Southern Blvd
Albany, NY 12209-1806

Phone 518-728-4292

Mailing address

90 Southern Blvd
Albany, NY 12209-1806

Phone 518-728-4292

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