MS. NOELLE ANNE DAVERSA
NPI 1619367778
Specialist in Smithtown, NY

Q: What is Noelle Daversa's NPI number?

The NPI number for Noelle Daversa is 1619367778. It was assigned to this individual provider in the NPPES registry on January 28, 2015.

Q: What is Noelle Daversa's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Noelle Daversa was last updated on January 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 28, 2015

208 HOLLY LANE, SMITHTOWN, NY 11787(631) 774-8665 Get Directions Write a Review

NPPES record last updated: January 28, 2015. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Ms. Noelle Anne Daversa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. NOELLE ANNE DAVERSA (NPI 1619367778) is an individual specialist in Smithtown, New York, licensed in New York (2233020) and active in the NPI registry since January 2015.

NPPES Registry Identity

NPI1619367778

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameMS. NOELLE ANNE DAVERSA

Location Address208 HOLLY LANESmithtown, NY 11787

Mailing Address208 Holly LaneSmithtown, NY 11787 · (631) 774-8665

Phone(631) 774-8665

Sole ProprietorNo

Enumeration DateJanuary 28, 2015

✔ NPI 1619367778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in NY · 2233020

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

208 HOLLY LANE, Smithtown, NY 11787

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Other Identifiers 1

Medicaid2238079NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Noelle Daversa's NPI number?

The NPI number for Noelle Daversa is 1619367778. It was assigned to this individual provider in the NPPES registry on January 28, 2015.

Where is Noelle Daversa located?

Noelle Daversa practices at 208 Holly Lane, Smithtown, NY 11787. The listed phone number is (631) 774-8665.

What is Noelle Daversa's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Noelle Daversa was last updated on January 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.