Provider Demographics
NPI:1104950849
Name:NEGRON, NOEMI (MA)
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51-39 AVE MAIN
Mailing Address - Street 2:SANTA ROSA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6653
Mailing Address - Country:US
Mailing Address - Phone:787-269-0427
Mailing Address - Fax:
Practice Address - Street 1:MAIN AVE. 51 # 39
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-269-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR519231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-4417Medicare ID - Type Unspecified