MEDICARE: NOID INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376039164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOID INC.

Provider Business Mailing Address
First Line	:	54 GARRETSON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 GARRETSON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2809
Country	:	US
Telephone Number	:	646-413-5473
Fax Number	:

Authorized Official
Title or Position	:	MS.ED
Name	:	ANNA ARTAMONOVA
Credential	:
Telephone Number	:	646-413-5473

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	07/05/2018

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Directions to “NOID INC. ” Practice Location

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