Provider Demographics
NPI:1124335351
Name:NOEL, PHILOMENA (RN)
Entity type:Individual
Prefix:
First Name:PHILOMENA
Middle Name:
Last Name:NOEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 VIVIAN CT
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4546
Mailing Address - Country:US
Mailing Address - Phone:516-655-4148
Mailing Address - Fax:
Practice Address - Street 1:3041 AVENUE U
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5126
Practice Address - Country:US
Practice Address - Phone:718-615-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4128491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse