Provider Demographics
NPI:1558180257
Name:NOYES, CONNOR EDWIN (DPT)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:EDWIN
Last Name:NOYES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1695 ELMWOOD AVE APT 319
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-2474
Mailing Address - Country:US
Mailing Address - Phone:802-373-7046
Mailing Address - Fax:
Practice Address - Street 1:1002 E LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-1033
Practice Address - Country:US
Practice Address - Phone:716-892-8811
Practice Address - Fax:716-892-3888
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY053209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist