Provider Demographics
NPI:1740275866
Name:NOBLE, KATHERINE KELLY (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:KELLY
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 W MAIN ST
Mailing Address - Street 2:SUITE 132
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4501
Mailing Address - Country:US
Mailing Address - Phone:203-363-0123
Mailing Address - Fax:475-619-9855
Practice Address - Street 1:2001 W MAIN ST
Practice Address - Street 2:SUITE 132
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4501
Practice Address - Country:US
Practice Address - Phone:203-363-0123
Practice Address - Fax:475-619-9855
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209754208000000X
CT041814208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics