Provider Demographics
NPI:1588832638
Name:MOORE, PAULA MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MARIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:FLARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:381 BERESFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610
Mailing Address - Country:US
Mailing Address - Phone:443-852-1484
Mailing Address - Fax:
Practice Address - Street 1:381 BERESFORD ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610
Practice Address - Country:US
Practice Address - Phone:443-852-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY579569163W00000X, 163WN0002X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care