Healthcare Provider Details

I. General information

NPI: 1831566843
Provider Name (Legal Business Name): NOBLE A THOMAS DC, MSACN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BROADWAY STE 1
HAWTHORNE NY
10532
US

IV. Provider business mailing address

153 BROADWAY STE 1
HAWTHORNE NY
10532-1147
US

V. Phone/Fax

Practice location:
  • Phone: 914-747-9200
  • Fax:
Mailing address:
  • Phone: 914-747-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number012866
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number012866
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: