Healthcare Provider Details

I. General information

NPI: 1164811741
Provider Name (Legal Business Name): JEAN-LUC NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JL NOEL MD

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 BELMONT ST
WORCESTER MA
01605-2903
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-8515
  • Fax: 508-334-6490
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number269449
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number285095
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number269449
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: