Individual
DR. NOAM NISSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5778
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5778
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11492401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042341446
—
NY
Enumeration date
08/07/2022
Last updated
08/07/2022
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