Provider Demographics
NPI:1225646235
Name:MOORE, ASSAF (MD)
Entity Type:Individual
Prefix:MR
First Name:ASSAF
Middle Name:
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:MEMORIAL SLOAN KETTERING CANER CENTER
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:212-961-6568
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:MEMORIAL SLOAN KETTERING CANCER CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-639-6800
Practice Address - Fax:212-717-3104
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP1052402085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology