Individual
DR. NOELLE MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 COMMACK RD STE 203, COMMACK, NY 11725-5020
(631) 444-9600
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
(631) 444-9600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
203397
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02148438
—
NY
01
—
16S381
EMPIRE BC.BS
NY
01
—
7743224
AETNA
NY
Enumeration date
07/12/2006
Last updated
04/27/2022
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