Provider Demographics
NPI:1528204484
Name:NOAM, MICHAL (MA, PT)
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:NOAM
Suffix:
Gender:F
Credentials:MA, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SHAAR HAGUY ST
Mailing Address - Street 2:
Mailing Address - City:RAMAT GAN
Mailing Address - State:RAMAT GAN
Mailing Address - Zip Code:52313
Mailing Address - Country:IL
Mailing Address - Phone:97252-830-3232
Mailing Address - Fax:
Practice Address - Street 1:6 SHAAR HAGUY ST
Practice Address - Street 2:
Practice Address - City:RAMAT GAN
Practice Address - State:RAMAT GAN
Practice Address - Zip Code:52313
Practice Address - Country:IL
Practice Address - Phone:97252-830-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015054-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics