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Maxwell Alex Moore, MD
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1962088419

Maxwell Alex Moore is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Maxwell Alex Moore practices in Stony Brook, NY and has the professional credentials of MD. The NPI Number for Maxwell Alex Moore is 1962088419 and holds a License No. (New York).

The current practice location address for Maxwell Alex Moore is 101 Nicolls Rd, Stony Brook, NY and can be reached out via phone at 631-444-3005.

Location: 101 Nicolls Rd, Stony Brook, NY, 11794-8101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962088419
Provider Name
Maxwell Alex Moore
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
101 Nicolls Rd, Stony Brook, NY, 11794-8101
Phone Number
631-444-3005
Fax Number
Provider Enumeration Date
03/23/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-8101
Phone Number
631-444-3005
Fax Number
person
Provider Business Mailing Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-8101
Phone Number
631-444-3005
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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