Miezra J Moore, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

679361 Issued in NY

Practice address

342 Waverly Ave
Medford, NY 11763-2550

Phone

(631) 220-1964

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1134590300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 WAVERLY AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632550",
            "telephone_number": "631-220-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 WAVERLY AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632550",
            "telephone_number": "631-220-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MIEZRA",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "679361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawndel Minter
• Jessica Mistretta
• Sandra Mitchell, LMHC
• Rebecca Molino
• Kristen Moore
• Rachel Ann Moore, PHARMD
• Mt Chiropractic, P.C.
• Richard Mugno II, SLP
• Stephanie Mullen
• Michelle Muller

• Registered Nurse in Medford, NY
• Providers in Medford, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.