Provider Demographics
NPI:1154468056
Name:NOFSKER, GARY L (MTBC, LCAT)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:L
Last Name:NOFSKER
Suffix:
Gender:M
Credentials:MTBC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 N HAIRPIN DR
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1570
Mailing Address - Country:US
Mailing Address - Phone:804-932-9721
Mailing Address - Fax:
Practice Address - Street 1:7123 N HAIRPIN DR
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1570
Practice Address - Country:US
Practice Address - Phone:804-932-9721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000835225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist