Provider Demographics
NPI:1235530437
Name:NOONAN, MARLEAH (MA)
Entity Type:Individual
Prefix:
First Name:MARLEAH
Middle Name:
Last Name:NOONAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 NORTHERN BLVD
Mailing Address - Street 2:FLOOR 5
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2221
Mailing Address - Country:US
Mailing Address - Phone:646-799-1817
Mailing Address - Fax:
Practice Address - Street 1:3300 NORTHERN BLVD
Practice Address - Street 2:FLOOR 5
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2221
Practice Address - Country:US
Practice Address - Phone:646-799-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health