Kanasha Moore, is a
Licensed Practical Nurse based in Elmwood Park, New Jersey. Kanasha Moore is licensed to practice in New Jersey (license number 26NP07724100) and her current practice location is
100 Broadway Ste A, Elmwood Park, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(201) 749-2045.
NPI number for Kanasha Moore is 1245910934 and her current mailing address is 100 Broadway Ste A, Elmwood Park, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245910934.
Provider's Profile
| Full Name | Kanasha Moore |
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| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 100 Broadway Ste A, Elmwood Park, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245910934
- Provider Enumeration Date: 07/19/2023
- Last Update Date: 07/19/2023
Medical Identifiers
Medical identifiers for Kanasha Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245910934 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 26NP07724100 (New Jersey) | 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. Kanasha Moore 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 |
|---|
Kanasha Moore,
100 Broadway Ste A,
Elmwood Park, NJ 07407-3088
Ph: (201) 796-0204 | Kanasha Moore,
100 Broadway Ste A,
Elmwood Park, NJ 07407-3088
Ph: (201) 749-2045 |
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