Provider Demographics
NPI:1740716711
Name:SOROKA, NOELLE (MSED, BCBA)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:SOROKA
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 MONROE ST APT 301
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-1791
Mailing Address - Country:US
Mailing Address - Phone:617-797-5397
Mailing Address - Fax:
Practice Address - Street 1:510 MONROE ST APT 301
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-1791
Practice Address - Country:US
Practice Address - Phone:617-797-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-11-7986103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst