Provider Demographics
NPI:1427548965
Name:NOORANI, AAQUIB (MD)
Entity Type:Individual
Prefix:DR
First Name:AAQUIB
Middle Name:
Last Name:NOORANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 SEAVIEW AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-226-8855
Mailing Address - Fax:718-226-1347
Practice Address - Street 1:475 SEAVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-8855
Practice Address - Fax:718-226-1347
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2019-01-08
Deactivation Date:2018-12-19
Deactivation Code:
Reactivation Date:2019-01-08
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program