Provider Demographics
NPI:1356192413
Name:NOE, NIKI (MD)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:
Last Name:NOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N OAK ST APT 1301
Mailing Address - Street 2:
Mailing Address - City:ROSSLYN
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2613
Mailing Address - Country:US
Mailing Address - Phone:310-508-3456
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program