Provider Demographics
NPI:1508021205
Name:TUBAYAN, NOREEN JOYCE
Entity Type:Individual
Prefix:MS
First Name:NOREEN
Middle Name:JOYCE
Last Name:TUBAYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 33RD ST
Mailing Address - Street 2:APT. 3F
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1241
Mailing Address - Country:US
Mailing Address - Phone:765-337-6535
Mailing Address - Fax:
Practice Address - Street 1:2545 33RD ST
Practice Address - Street 2:APT. 3F
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1241
Practice Address - Country:US
Practice Address - Phone:765-337-6535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026748-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist