Provider Demographics
NPI:1326232869
Name:ROOP, NOELLE PATRISE (MED)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:PATRISE
Last Name:ROOP
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2611
Mailing Address - Country:US
Mailing Address - Phone:267-346-4309
Mailing Address - Fax:
Practice Address - Street 1:23 SPENCER AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2611
Practice Address - Country:US
Practice Address - Phone:267-346-4309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health