1114951944 NPI number — DR. SUZANNE MARIE NOONAN AU.D., CCC-A, FAAA

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114951944 NPI number — DR. SUZANNE MARIE NOONAN AU.D., CCC-A, FAAA

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

NOONAN

Provider First Name:

SUZANNE

Provider Middle Name:

MARIE

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

AU.D., CCC-A, FAAA

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

NOONAN-DE BLIJ

Provider Other First Name:

SUZANNE

Provider Other Middle Name:

MARIE

Provider Other Name Prefix Text:

MISS

Provider Other Name Suffix Text:

Provider Other Credential Text:

MA, CCC-A, FAAA

Provider Other Last Name Type Code:

1

NPI Number:

1114951944

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/19/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

525 LONGHORN CRES

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROCKVILLE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20850-5704

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

301-926-2774

Provider Business Mailing Address Fax Number:

301-946-2435

Provider First Line Business Practice Location Address:

3913 FERRARA DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SILVER SPRING

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

20906-4709

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

301-946-2434

Provider Business Practice Location Address Fax Number:

301-946-2435

Provider Enumeration Date:

07/10/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 231H00000X , with the licence number:  770 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 231HA2400X , with the licence number: 770 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 231HA2500X , with the licence number: 770 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 237600000X , with the licence number: 770 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 521981246002 . This is a "CIGNA PROVIDER ID NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 640002741 . This is a "RAILROAD MEDICARE PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 1902342 . This is a "UNITED HEALTHCARE PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 241012 . This is a "OPTIMUM CHOICE PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 241012 . This is a "MAMSI PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 521981246DA . This is a "PREFERRED HEALTH NETWORK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 802624 . This is a "JOHNS HOPKINS HC GROUP ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: L117HE . This is a "BCBS OF MD GROUP ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: L332HE . This is a "BCBS OF MD ALT. GROUP ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 095100500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 69280 . This is a "AMERIGROUP PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 241012 . This is a "ALLIANCE PPO PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 241012 . This is a "MDIPA PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: NOONAN . This is a "INOVA PROVIDER ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 0814410 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 0814410 . This is a "US HEALTHCARE PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 20420002 . This is a "BCBS OF DC PROV ID" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".