Provider Demographics
NPI:1851534796
Name:NOEL-ROBERTS, ALISHA
Entity Type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:
Last Name:NOEL-ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:13 THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-2313
Mailing Address - Country:US
Mailing Address - Phone:631-245-8676
Mailing Address - Fax:
Practice Address - Street 1:13 THOMAS DR
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-2313
Practice Address - Country:US
Practice Address - Phone:631-245-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279747164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse