Provider Demographics
NPI:1508847476
Name:NOBLE, JEYASEELAN J (MD FACS)
Entity Type:Individual
Prefix:
First Name:JEYASEELAN
Middle Name:J
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:402 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1818
Mailing Address - Country:US
Mailing Address - Phone:215-752-4020
Mailing Address - Fax:215-752-8807
Practice Address - Street 1:402 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1818
Practice Address - Country:US
Practice Address - Phone:215-752-4020
Practice Address - Fax:215-752-8807
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD034497L208200000X
NJMA26512208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA114162E48Medicare PIN
E55474Medicare UPIN