Provider Demographics
NPI:1104971977
Name:JOSEPH A. DE NOIA
Entity type:Organization
Organization Name:JOSEPH A. DE NOIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DE NOIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-638-4455
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-0487
Mailing Address - Country:US
Mailing Address - Phone:845-638-4455
Mailing Address - Fax:845-634-3889
Practice Address - Street 1:230 CONGERS RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6256
Practice Address - Country:US
Practice Address - Phone:845-638-4455
Practice Address - Fax:845-634-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002407-1111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY911879OtherMPN
NY4635494OtherAETNA
NY4635494OtherAETNA
NYX13831Medicare PIN