Most Relevant Information
Provider Data
| NPI Number: | 1003658758 |
| Provider Name: | NOELLE LAVINE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/12/2024 |
| Last Updated: | 06/12/2024 |
Provider Practice Location
136 PARKWAY DR
COBLESKILL
NY
120435150
Practice Location Phone/Fax
| Phone: | 5182342555 |
| Fax: |
Provider Mailing Location
136 PARKWAY DR
COBLESKILL
NY
120435150
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |