Timothy W Moon (NPI# 1215957832, PAC ID# 8729072046) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1215957832 |
| PAC ID by PECOS | 8729072046 |
| Professional Enrollment ID | I20040412000098 |
| Full Name | Timothy W Moon |
| Address |
173 E Main St Suite 1 Gouverneur NY 13642-1510 |
| Gender | M |
| Credential | DO |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | FAMILY PRACTICE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 331315 | GOUVERNEUR HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 173 E Main St, Suite 1, Gouverneur, NY 13642-1510 | ||
| 173 E Main St, Gouverneur, NY 13642-1510 |
| Street Address |
173 E MAIN ST SUITE 1 |
| City | GOUVERNEUR |
| State | NY |
| Zip | 13642-1510 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda L Hance | Nurse Practitioner | Canton-potsdam Hospital | 77 W Barney St, Cph Specialty Suites At Gvnr, Governed, NY 13642-1040 |
| Edward L Reason | Internal Medicine | 77 W Barney St, Gouverneur, NY 13642-1040 | |
| Payam Hadian | Family Medicine | Canton-potsdam Hospital | 77 W Barney St, Cph Specialty Suites At Gvnr, Governed, NY 13642-1040 |
| Laurie F Brown | Nurse Practitioner | Canton-potsdam Hospital | 77 W Barney St, Cph Specialty Suites At Gvnr, Governed, NY 13642-1040 |
| Theresa W Samways | Clinical Social Worker | Canton-potsdam Hospital | 77 W Barney St, Cph Specialty Suites At Gvnr, Governed, NY 13642-1040 |
| Ernie S Cougler | Nurse Practitioner | United Cerebral Palsy Association of The North Country Inc | 77 W Barney St, Gouverneur, NY 13642-1040 |
| Jie He | Internal Medicine | Delphi Hospitalist Services LLC | 77 W Barney St, Gouverneur, NY 13642-1040 |
| Ashley Rodgers | Optometry | M B Kayani Physician PC | 77 W Barney St, Gouverneur, NY 13642-1040 |
| Ali N Ahmed | Physician Assistant | Delphi Hospitalist Services LLC | 77 W Barney St, Gouverneur, NY 13642-1040 |
| Inez M Reyna | Optometry | M B Kayani Physician PC | 77 W Barney St, Gouverneur, NY 13642-1040 |
| Find all physicians in zip 13642 | |||
| City | GOUVERNEUR |
| Zip Code | 13642 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | GOUVERNEUR + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Timothy W Moon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.