MEDICARE: DR. DANIEL ADAM NOLL PHD

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	103T00000X	Psychologist	5410	NJ

General Provider Information

NPI Number	:	1558327239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ADAM NOLL PHD

Provider Business Mailing Address
First Line	:	16 SAND PIPER DR
Second Line	:
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879-3426
Country	:	US
Telephone Number	:	732-306-9609
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 SAND PIPER DR
Second Line	:
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879-3426
Country	:	US
Telephone Number	:	732-306-9609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	07/21/2022

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