Healthcare Provider Details

I. General information

NPI: 1821139502
Provider Name (Legal Business Name): OLGA NOSKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S AVENUE A
YUMA AZ
85364-7127
US

IV. Provider business mailing address

17 ELM AVE 3RD FLOOR
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-2000
  • Fax:
Mailing address:
  • Phone: 551-277-2190
  • Fax: 551-277-2191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberW6513
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number80985
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number236277
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME181864
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME181864
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA08329700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: