Provider Demographics
NPI:1700197605
Name:KOENIGSBERG, NOAM YESHAYA
Entity Type:Individual
Prefix:DR
First Name:NOAM
Middle Name:YESHAYA
Last Name:KOENIGSBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 MANDARIN DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7418
Mailing Address - Country:US
Mailing Address - Phone:305-985-2161
Mailing Address - Fax:
Practice Address - Street 1:960 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE 410
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3326
Practice Address - Country:US
Practice Address - Phone:305-985-2161
Practice Address - Fax:305-763-8475
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2635902084P0800X
FLME 1213832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry