Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Timothy W. Moon, DO, PLLC

Organization Family Medicine Physician · NPI 1194945410

Timothy W. Moon, DO, PLLC is a Family Medicine Physician in Gouverneur, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

77 W Barney St
Gouverneur, NY 13642-1040
Phone: (315) 287-3285
Fax: (315) 287-3280
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 224227 (NY)

Record details

NPI number1194945410
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Moon — President · (315) 486-2987
NPI enumeratedApril 27, 2007
Last updated in NPPESNovember 10, 2011
Mailing address77 W Barney St, Gouverneur, NY 13642-1040

Other providers in Gouverneur