Provider Demographics
NPI:1114951944
Name:NOONAN, SUZANNE MARIE (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:NOONAN
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:NOONAN-DE BLIJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-A, FAAA
Mailing Address - Street 1:525 LONGHORN CRES
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5704
Mailing Address - Country:US
Mailing Address - Phone:301-926-2774
Mailing Address - Fax:301-946-2435
Practice Address - Street 1:3913 FERRARA DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4709
Practice Address - Country:US
Practice Address - Phone:301-946-2434
Practice Address - Fax:301-946-2435
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD770231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521981246002OtherCIGNA PROVIDER ID NUMBER
MD640002741OtherRAILROAD MEDICARE PROV ID
MD1902342OtherUNITED HEALTHCARE PROV ID
MD241012OtherOPTIMUM CHOICE PROV ID
MD241012OtherMAMSI PROVIDER ID
MD521981246DAOtherPREFERRED HEALTH NETWORK
MD802624OtherJOHNS HOPKINS HC GROUP ID
MDL117HEOtherBCBS OF MD GROUP ID
MDL332HEOtherBCBS OF MD ALT. GROUP ID
MD095100500Medicaid
MD69280OtherAMERIGROUP PROVIDER ID
MD241012OtherALLIANCE PPO PROV ID
MD241012OtherMDIPA PROVIDER ID
VANOONANOtherINOVA PROVIDER ID
MD0814410OtherAETNA PROVIDER ID
MD0814410OtherUS HEALTHCARE PROV ID
DC20420002OtherBCBS OF DC PROV ID
MD241012OtherOPTIMUM CHOICE PROV ID
MD521981246DAOtherPREFERRED HEALTH NETWORK