MEDICARE: MRS. JOYCE LOUISE NOONAN PT

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
1	225100000X	Physical Therapist	003355	NY

General Provider Information

NPI Number	:	1982750147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE LOUISE NOONAN PT

Provider Business Mailing Address
First Line	:	8 ERIE ST
Second Line	:
City	:	PORT JEFFERSON STATION
State	:	NY
Zip	:	11776-3304
Country	:	US
Telephone Number	:	631-331-3150
Fax Number	:	631-331-3150

Provider Business Practice Location Address
First Line	:	8 ERIE ST
Second Line	:
City	:	PORT JEFFERSON STATION
State	:	NY
Zip	:	11776-3304
Country	:	US
Telephone Number	:	631-331-3150
Fax Number	:	631-331-3150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2007
Last Update Date	:	07/08/2007

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