Healthcare Provider Details

I. General information

NPI: 1568468486
Provider Name (Legal Business Name): NOEL T THAYER AUDIOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NOEL T STASKEL MA, CCC-A

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 STONE PL STE 203
BRONXVILLE NY
10708-3430
US

IV. Provider business mailing address

1 STONE PL SUITE 203
BRONXVILLE NY
10708-3426
US

V. Phone/Fax

Practice location:
  • Phone: 914-337-0018
  • Fax: 914-337-0541
Mailing address:
  • Phone: 914-337-0018
  • Fax: 914-337-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: