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General NPI Number Information
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NPI Number | 1922018282
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Entity Type | Individual
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Provider Name | NOCI DEDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 185 OLD MILITARY RD
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City | LAKE PLACID
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State | NY
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Zip | 12946-1939
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Country | US
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Telephone | 518-523-2464
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Fax | 518-523-1401
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Provider Business Mailing Address
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Address Line | 122 BLOOMINGDALE AVE APT 1
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1223
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Country | US
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Telephone | 518-523-3496
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Fax | 518-523-1401
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 232650
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License Number State | NY
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