Provider Demographics
NPI:1336629237
Name:NOONAN, VICTORIA MARIE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:MARIE
Last Name:NOONAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:MARIE
Other - Last Name:LAMARCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2631
Mailing Address - Country:US
Mailing Address - Phone:516-248-3702
Mailing Address - Fax:
Practice Address - Street 1:123 STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2631
Practice Address - Country:US
Practice Address - Phone:516-248-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381407-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics