Provider Demographics
NPI:1972394914
Name:MOSHER, KAMERON DAVID
Entity type:Individual
Prefix:
First Name:KAMERON
Middle Name:DAVID
Last Name:MOSHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:GLENS FALLS HOSPITAL-CREDENTIALING
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801
Mailing Address - Country:US
Mailing Address - Phone:518-926-6992
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:1134 STATE ROUTE 29
Practice Address - Street 2:GREENWICH MEDICAL CENTER
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834
Practice Address - Country:US
Practice Address - Phone:518-692-9861
Practice Address - Fax:518-692-7947
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program