Provider Demographics
NPI:1205211620
Name:NOBLE, JOHN TIMOTHY (NP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TIMOTHY
Last Name:NOBLE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 STRANG BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2938
Mailing Address - Country:US
Mailing Address - Phone:914-233-3008
Mailing Address - Fax:914-233-3011
Practice Address - Street 1:2649 STRANG BLVD STE 206
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2938
Practice Address - Country:US
Practice Address - Phone:914-233-3008
Practice Address - Fax:914-233-3011
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF307438-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health