Provider Demographics
NPI:1811371693
Name:NOH, ADA
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:
Last Name:NOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 QUAIL CT
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-2571
Mailing Address - Country:US
Mailing Address - Phone:724-612-7202
Mailing Address - Fax:
Practice Address - Street 1:2401 ROUTE 130 S
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3020
Practice Address - Country:US
Practice Address - Phone:856-786-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist