Provider Demographics
NPI:1992136766
Name:NOFER, JANINE
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:NOFER
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 1:54 CLIFFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2505
Mailing Address - Country:US
Mailing Address - Phone:631-524-0115
Mailing Address - Fax:
Practice Address - Street 1:5225 NESCONSET HWY STE 30
Practice Address - Street 2:NEW YORK THERAPY PLACEMENT SERVICES
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2060
Practice Address - Country:US
Practice Address - Phone:631-476-0967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY996311001171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor