Provider Demographics
NPI:1154672749
Name:IONADI, NOELLE (PT, DPT, PA-C)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:IONADI
Suffix:
Gender:F
Credentials:PT, DPT, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LONGSTREET LN
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-2741
Mailing Address - Country:US
Mailing Address - Phone:732-406-6442
Mailing Address - Fax:
Practice Address - Street 1:2701 QUEENS PLZ N FL 10
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4022
Practice Address - Country:US
Practice Address - Phone:877-514-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00444800363A00000X
NY021006-1363A00000X
NJ40QA01466200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist