Provider Demographics
NPI:1407369416
Name:NOOR KAZI LLC
Entity Type:Organization
Organization Name:NOOR KAZI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-200-9326
Mailing Address - Street 1:106 FORT WASHINGTON AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4723
Mailing Address - Country:US
Mailing Address - Phone:701-200-9326
Mailing Address - Fax:718-585-0009
Practice Address - Street 1:679 EAST 138 STREET, BRONX
Practice Address - Street 2:FL.1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454
Practice Address - Country:US
Practice Address - Phone:718-585-0008
Practice Address - Fax:718-585-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2777852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04160972Medicaid