Healthcare Provider Details

I. General information

NPI: 1861506776
Provider Name (Legal Business Name): NOAH S SIEGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HUNTINGTON AVE
BOSTON MA
02115-6303
US

IV. Provider business mailing address

800 HUNTINGTON AVE
BOSTON MA
02115-6303
US

V. Phone/Fax

Practice location:
  • Phone: 617-936-6160
  • Fax:
Mailing address:
  • Phone: 617-936-6160
  • Fax: 617-936-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number204511
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberMD14913
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: