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

Spencer Conrad Moore

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639971617

Spencer Conrad Moore is a Student in an Organized Health Care Education/Training Program in Newark, New Jersey. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

150 Bergen St
Newark, NJ 07103-2496
Phone: (973) 972-4300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1639971617
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 27, 2025
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025
Mailing address183 S Orange Ave, Newark, NJ 07103-2757

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