Provider Demographics
NPI:1962534404
Name:NOBLE, MARY (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:185 STATE ROUTE 36 BLDG E
Mailing Address - Street 2:MONMOUTH PARK CORPORATE CENTER 1
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1341
Mailing Address - Country:US
Mailing Address - Phone:866-598-5574
Mailing Address - Fax:732-229-2950
Practice Address - Street 1:185 STATE ROUTE 36 BLDG E
Practice Address - Street 2:MONMOUTH PARK CORPORATE CENTER 1
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1341
Practice Address - Country:US
Practice Address - Phone:866-598-5574
Practice Address - Fax:732-229-2950
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA505602083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine