National Provider Identifier Database

SHANNEN MOORE
Pediatrics


Contact Information

SHANNEN MOORE
8 WATERMAN RD
BOSTON, MA02131-2218
Phone: 857-345-0003
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X
Nurse Anesthetist, Certified Registered 367500000X
Pediatrics 163WP0200X

* Indicates primary specialty

NPI Profile & details for SHANNEN MOORE

NPI Number 1083092977
Credentials
Entity Individual
Enumeration date 05/11/2015
Last updated 01/27/2026 - About 4 months ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 383018
  • NY License #: 701502
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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