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General NPI Number Information
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NPI Number | 1922549054
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Entity Type | Individual
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Provider Name | YISROEL NOSKOW
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Gender | Male
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 2323 NE 26TH AVE STE 107
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1147
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Country | US
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Telephone | 954-406-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 FALLS LN
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City | PARKLAND
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State | FL
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Zip | 33067-0907
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Country | US
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Telephone |
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN23119
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License Number State | FL
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