Provider Demographics
NPI:1376168872
Name:MAMOOR, NOREEN
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:MAMOOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 EVERDELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4215
Mailing Address - Country:US
Mailing Address - Phone:631-835-8540
Mailing Address - Fax:
Practice Address - Street 1:6729 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7063
Practice Address - Country:US
Practice Address - Phone:718-456-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health