Provider Demographics
NPI:1619215563
Name:NOESON, PAUL E (LPN)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:NOESON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 ROUTE 98
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:NY
Mailing Address - Zip Code:14065-9747
Mailing Address - Country:US
Mailing Address - Phone:716-492-5224
Mailing Address - Fax:
Practice Address - Street 1:11675 ROUTE 98
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:NY
Practice Address - Zip Code:14065-9747
Practice Address - Country:US
Practice Address - Phone:716-492-5224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222000-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse