Provider Demographics
NPI:1114311974
Name:MOORE, THOMAS (CPBMT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MOORE
Suffix:
Gender:M
Credentials:CPBMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4946
Mailing Address - Country:US
Mailing Address - Phone:855-606-5426
Mailing Address - Fax:412-321-0128
Practice Address - Street 1:1020 MADISON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4946
Practice Address - Country:US
Practice Address - Phone:855-606-5426
Practice Address - Fax:412-321-0128
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other