NPI 1306477518

Sam Eugene Moore, AMBULETTE

Practitioner Driver Poughkeepsie, NY

Practice location

Address: 33 Du Bois Ave, Poughkeepsie, NY 12601-2140
Phone: (845) 464-4162

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 5363887522 (NY)

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Registry record

NPI: 1306477518
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jan 2020
Record last updated: 28 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.