Provider Demographics
NPI:1932763257
Name:ROBINSON, NOELLE R
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:R
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 OLD KNOLLWOOD ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2811
Mailing Address - Country:US
Mailing Address - Phone:646-642-7849
Mailing Address - Fax:
Practice Address - Street 1:300 GEORGE ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6624
Practice Address - Country:US
Practice Address - Phone:203-688-2397
Practice Address - Fax:203-688-3293
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist