Individual
NOELLE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 HUDSON AVE, GLENS FALLS, NY 12801-4313
(518) 793-4477
Mailing address
45 HUDSON AVE, PO BOX 144, GLENS FALLS, NY 12801-4313
(518) 793-4477
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
146970
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000416199001
BLUE SHIELD
NY
05
—
00912010
—
NY
01
—
040426007601
FIDELIS
NY
01
—
10001475
CDPHP
NY
01
—
15124
MVP
NY
01
—
78E642
BLUE CROSS
NY
Enumeration date
06/10/2005
Last updated
07/08/2007
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