Provider Demographics
NPI:1124367941
Name:RADWANSKI, NOEL E (DVM)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:E
Last Name:RADWANSKI
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W RIDGE PIKE BLDG B
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1191
Mailing Address - Country:US
Mailing Address - Phone:484-567-7999
Mailing Address - Fax:845-677-9984
Practice Address - Street 1:625 W RIDGE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1180
Practice Address - Country:US
Practice Address - Phone:845-677-9994
Practice Address - Fax:484-567-7998
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00624200174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian