Basic Information
Provider Information
NPI: 1073648390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IORDACHE
FirstName: NOELLE
MiddleName: H
NamePrefix: MRS.
NameSuffix:  
Credential: PT, MPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 39 SANDOR DR
Address2:  
City: PRINCETON
State: NJ
PostalCode: 085409500
CountryCode: US
TelephoneNumber: 7324380312
FaxNumber:  
Practice Location
Address1: 1 ROSSMOOR DR
Address2: SUITE 103
City: MONROE TOWNSHIP
State: NJ
PostalCode: 088311566
CountryCode: US
TelephoneNumber: 6098609913
FaxNumber: 6098609915
Other Information
ProviderEnumerationDate: 02/23/2007
LastUpdateDate: 10/01/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00606600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home