Vandy Moore, BA

Individual provider Active NPI Community Health Worker · Waterbury, CT

NPI 1154763308 · NPPES record last updated Jul 29, 2013

Key facts

NPI
1154763308
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
141 E Main St
Waterbury, CT 06702-2310
Phone
(203) 574-9000
Fax
(203) 574-9006
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

141 E Main St
Waterbury, CT 06702-2310

Mailing address

141 E Main St
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other providers in Waterbury, CT

All providers in Waterbury, CT · Community Health Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.