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NPI Code Detail

MEDICARE: KELLY ELIZABETH NOBLE M.D.

MEDICARE: KELLY ELIZABETH NOBLE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician300345NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619361821
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ELIZABETH NOBLE M.D.
Provider Business Mailing Address
First Line : 85 S WEST ST
Second Line :
City : HOMER
State : NY
Zip : 13077-1542
Country : US
Telephone Number : 607-753-3797
Fax Number :
Provider Business Practice Location Address
First Line : 3 TECHNOLOGY PL
Second Line :
City : HOMER
State : NY
Zip : 13077-1526
Country : US
Telephone Number : 607-753-3774
Fax Number : 607-753-3947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2015
Last Update Date : 07/07/2025

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