Healthcare Provider Details

I. General information

NPI: 1861357584
Provider Name (Legal Business Name): CARMAN NOEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 DECLARATION DR APT D
YORKTOWN VA
23692-2639
US

IV. Provider business mailing address

4200 DECLARATION DR APT D
YORKTOWN VA
23692-2639
US

V. Phone/Fax

Practice location:
  • Phone: 347-926-9691
  • Fax:
Mailing address:
  • Phone: 347-926-9691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: