Provider Demographics
NPI:1407653538
Name:NOGLAK, ARTHUR GARY (PRS)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:GARY
Last Name:NOGLAK
Suffix:
Gender:
Credentials:PRS
Other - Prefix:MR
Other - First Name:ARTHUR
Other - Middle Name:GARY
Other - Last Name:NOGLAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PRS
Mailing Address - Street 1:14445 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1957
Mailing Address - Country:US
Mailing Address - Phone:216-677-8177
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:14445 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-1957
Practice Address - Country:US
Practice Address - Phone:216-677-8177
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005559175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist