Provider Demographics
NPI:1205461704
Name:SHRIBER, NOAH STERN (DO)
Entity type:Individual
Prefix:MR
First Name:NOAH
Middle Name:STERN
Last Name:SHRIBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WALTHAM ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5406
Mailing Address - Country:US
Mailing Address - Phone:781-861-8814
Mailing Address - Fax:781-860-7397
Practice Address - Street 1:47 WALTHAM ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5406
Practice Address - Country:US
Practice Address - Phone:781-861-8814
Practice Address - Fax:781-860-7397
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5332156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician