Provider Demographics
NPI:1497159438
Name:LE PERTEL, NOEMIE (DACM, LAC, LMT)
Entity Type:Individual
Prefix:DR
First Name:NOEMIE
Middle Name:
Last Name:LE PERTEL
Suffix:
Gender:F
Credentials:DACM, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 W 187TH ST APT 7C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1216
Mailing Address - Country:US
Mailing Address - Phone:917-916-7771
Mailing Address - Fax:
Practice Address - Street 1:825 W 187TH ST APT 7A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1216
Practice Address - Country:US
Practice Address - Phone:917-916-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027430225700000X
NY25005357171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty