Provider Demographics
NPI:1073748018
Name:KAMAL-MOSTAFAVI, NOREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NOREEN
Middle Name:
Last Name:KAMAL-MOSTAFAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NOREEN
Other - Middle Name:
Other - Last Name:KAMAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14 BLEEKER PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3727
Mailing Address - Country:US
Mailing Address - Phone:201-978-7146
Mailing Address - Fax:
Practice Address - Street 1:3860 VICTORY BLVD FL 1
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6720
Practice Address - Country:US
Practice Address - Phone:718-370-2222
Practice Address - Fax:718-351-0311
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09580200207V00000X
NY27741821207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology