Provider Demographics
NPI:1609035583
Name:NOBLE, KIMBERLY G (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:G
Last Name:NOBLE
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 1:575 W 181ST ST
Mailing Address - Street 2:WASHINGTON HEIGHTS FAMILY HEALTH CLINIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033
Mailing Address - Country:US
Mailing Address - Phone:917-533-3522
Mailing Address - Fax:
Practice Address - Street 1:575 W 181ST ST
Practice Address - Street 2:WASHINGTON HEIGHTS FAMILY HEALTH CLI
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033
Practice Address - Country:US
Practice Address - Phone:212-342-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY251439208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program