Basic Information
| Provider Information | |||||||||
| NPI: | 1003141193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOORE | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | JO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 CHATSWOOD GROVE | ||||||||
| Address2: | BIRKENHEAD | ||||||||
| City: | AUCKLAND | ||||||||
| State: | NORTH SHORE | ||||||||
| PostalCode: | 0626 | ||||||||
| CountryCode: | NZ | ||||||||
| TelephoneNumber: | 6494807617 | ||||||||
| FaxNumber: | 6495706520 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 PLEASANT VIEW ROAD | ||||||||
| Address2: | PANMURE | ||||||||
| City: | AUCKLAND | ||||||||
| State: | EAST AUCKLAND | ||||||||
| PostalCode: | 1072 | ||||||||
| CountryCode: | NZ | ||||||||
| TelephoneNumber: | 6495706519 | ||||||||
| FaxNumber: | 6495706520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2009 | ||||||||
| LastUpdateDate: | 10/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 60056531 | WA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.