Provider Demographics
NPI:1639266703
Name:MOORE, ANNE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E 72ND ST OFC 300
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4635
Mailing Address - Country:US
Mailing Address - Phone:212-746-0373
Mailing Address - Fax:212-746-7481
Practice Address - Street 1:428 E 72ND ST OFC 300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4635
Practice Address - Country:US
Practice Address - Phone:212-746-2085
Practice Address - Fax:212-746-3305
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY112094207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC12432Medicare UPIN