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

Michael Victor Andrew Moore

Individual provider Physician Assistant · NPI 1104754233

Michael Victor Andrew Moore is a Physician Assistant in Valley Stream, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2026

Practice location Address checks out

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone: (516) 321-7591
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)

Record details

NPI number1104754233
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 11, 2026
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026
Mailing address10988 203rd St, Saint Albans, NY 11412-1335

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