Provider Demographics
NPI:1942817242
Name:NOONAN, GINA BELLA (LAC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:BELLA
Last Name:NOONAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLD HILL RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-2015
Mailing Address - Country:US
Mailing Address - Phone:973-255-6369
Mailing Address - Fax:
Practice Address - Street 1:5 COLD HILL RD
Practice Address - Street 2:
Practice Address - City:MENDHAM TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07945-2015
Practice Address - Country:US
Practice Address - Phone:973-255-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00147000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist