Healthcare Provider Details

I. General information

NPI: 1790523454
Provider Name (Legal Business Name): NOA KREMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E 95TH ST
NEW YORK NY
10128-4012
US

IV. Provider business mailing address

235 E 95TH ST
NEW YORK NY
10128-4012
US

V. Phone/Fax

Practice location:
  • Phone: 917-294-8977
  • Fax:
Mailing address:
  • Phone: 917-294-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number34046201
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: