Provider Demographics
NPI:1780242511
Name:NOGA, MADISYNN (DPM)
Entity type:Individual
Prefix:DR
First Name:MADISYNN
Middle Name:
Last Name:NOGA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7823 OAK GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7127
Mailing Address - Country:US
Mailing Address - Phone:513-356-1031
Mailing Address - Fax:
Practice Address - Street 1:7775 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2519
Practice Address - Country:US
Practice Address - Phone:561-258-9443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135001031213ES0103X
FLPO4411213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery