David Allan Moore
Individual provider Active NPI Taxi · Horseheads, NY
NPI 1477077683 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1477077683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Taxi 344600000X
- License
- 611741718 (NY)
- Practice address
- 3159 Lake Road
Horseheads, NY 14845 - Phone
- (607) 280-4282
- NPI assigned
- Jul 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 611741718 | NY | MD | Taxi |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Taxi | 344600000X | 611741718 | NY | Yes |
Addresses
Primary practice location
3159 Lake Road
Horseheads, NY 14845
Mailing address
3159 Lake Rd
Horseheads, NY 14845-3117
Phone (607) 280-4282
Other providers in Horseheads, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.