Provider Demographics
NPI:1518628205
Name:PRESTI, NOELLE NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:NICOLE
Last Name:PRESTI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8313 SKY CANYON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7936
Mailing Address - Country:US
Mailing Address - Phone:732-768-3769
Mailing Address - Fax:
Practice Address - Street 1:8313 SKY CANYON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7936
Practice Address - Country:US
Practice Address - Phone:732-768-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2995225100000X
NY047632225100000X
VA2305214006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist