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General NPI Number Information
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NPI Number | 1841475126
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Entity Type | Individual
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Provider Name | GENIE NOELLE BALL PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 32 STRAWBERRY HILL CT SUITE 11001
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City | STAMFORD
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State | CT
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Zip | 06902-2594
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Country | US
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Telephone | 203-276-4400
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Fax | 203-276-4401
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Provider Business Mailing Address
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Address Line | 32 STRAWBERRY HILL CT SUITE 11001
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City | STAMFORD
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State | CT
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Zip | 06902-2594
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Country | US
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Telephone | 203-276-4400
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Fax | 203-276-4401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2003
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License Number State | CT
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