Provider Demographics
NPI:1558018549
Name:NOORANI, MAHEEN
Entity Type:Individual
Prefix:
First Name:MAHEEN
Middle Name:
Last Name:NOORANI
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 1:309 RIVER MEWS LN
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-3107
Mailing Address - Country:US
Mailing Address - Phone:516-603-5058
Mailing Address - Fax:
Practice Address - Street 1:3612 36TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1334
Practice Address - Country:US
Practice Address - Phone:718-819-8623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst