Daversa, Noelle Anne
Daversa, Noelle Anne is an individual health care provider with primary practice located at 208 Holly Lane , Smithtown NY 11787. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Daversa, Noelle Anne can be contacted via phone (631) 774-8665.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 2233020 | New York |
Profile Details
| NPI number | 1619367778 |
|---|---|
| LBN Legal business name | Daversa, Noelle Anne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 28th, 2015 |
| Last updated | Jan 28th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619367778 | NPPES |
| New York | MEDICAID | 2238079 |
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