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Ms. Noelle Anne Daversa
Specialist in Smithtown, New York
NPI 1619367778

Noelle Anne Daversa is a Specialist based in Smithtown, NY. Noelle Anne Daversa practices in Smithtown, NY. The NPI Number for Noelle Anne Daversa is 1619367778 and holds a License No. 2233020 (New York).

The current practice location address for Noelle Anne Daversa is 208 Holly Lane, Smithtown, NY and can be reached out via phone at 631-774-8665.

Location: 208 Holly Lane, Smithtown, NY, 11787
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619367778
Provider Name
Noelle Anne Daversa
Credential
Provider Entity Type
Individual
Gender
Female
Address
208 Holly Lane, Smithtown, NY, 11787
Phone Number
631-774-8665
Fax Number
Provider Enumeration Date
01/28/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2238079 05 NY
institution
Provider Business Practice Location Address Details
Address
208 Holly Lane
City
Smithtown
State
New York
Zip
11787
Phone Number
631-774-8665
Fax Number
person
Provider Business Mailing Address Details
Address
208 Holly Lane
City
Smithtown
State
New York
Zip
11787
Phone Number
631-774-8665
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
2233020 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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