Provider Demographics
NPI:1508049222
Name:NOEDDEGAARD, LOUISE SCHULTZ (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:SCHULTZ
Last Name:NOEDDEGAARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 JACKSON ST
Mailing Address - Street 2:APT. 4C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2499
Mailing Address - Country:US
Mailing Address - Phone:917-402-7880
Mailing Address - Fax:
Practice Address - Street 1:130 JACKSON ST
Practice Address - Street 2:APT. 4C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2499
Practice Address - Country:US
Practice Address - Phone:917-402-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT49449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine