Dr Randolph Moredock, PHD is a
Marriage & Family Therapist based in Brockport, New York. Dr Randolph Moredock is licensed to practice in New York (license number 06 000512) and his current practice location is
60 Centennial Ave, Brockport, New York. He can be reached at his office (for appointments etc.) via phone at
(585) 637-5001.
NPI number for Dr Randolph Moredock is 1679585707 and his current mailing address is 60 Centennial Ave, Brockport, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679585707.
Healthcare Provider's Profile
| Full Name | Dr Randolph Moredock |
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| Gender | Male |
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| Speciality | Marriage & Family Therapist |
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| Location | 60 Centennial Ave, Brockport, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1679585707
- Provider Enumeration Date: 08/13/2006
- Last Update Date: 08/22/2007
Medical Identifiers
Medical identifiers for Dr Randolph Moredock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679585707 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 18 002810 (New York) | Secondary |
| 106H00000X | Marriage & Family Therapist | 06 000512 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Randolph Moredock is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Randolph Moredock, PHD
60 Centennial Ave,
Brockport, NY 14420-2328
Ph: (585) 637-5001 | Dr Randolph Moredock, PHD
60 Centennial Ave,
Brockport, NY 14420-2328
Ph: (585) 637-5001 |
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