Provider Demographics
NPI:1598882490
Name:MOORE, BINH T (OD)
Entity Type:Individual
Prefix:DR
First Name:BINH
Middle Name:T
Last Name:MOORE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-2122
Mailing Address - Country:US
Mailing Address - Phone:203-324-1769
Mailing Address - Fax:
Practice Address - Street 1:7 STONY HILL RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1030
Practice Address - Country:US
Practice Address - Phone:203-794-0095
Practice Address - Fax:203-797-8602
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005870152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist