Provider Demographics
NPI:1609646892
Name:NOE, DANIEL (IDC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:NOE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 LEE RD
Mailing Address - Street 2:
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02542-1313
Mailing Address - Country:US
Mailing Address - Phone:508-968-6582
Mailing Address - Fax:508-968-6581
Practice Address - Street 1:5201 LEE RD
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02542-1313
Practice Address - Country:US
Practice Address - Phone:508-968-6582
Practice Address - Fax:508-968-6581
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other