Provider Demographics
NPI:1558655696
Name:HOSSEINI, NOOSHIN (MD)
Entity Type:Individual
Prefix:
First Name:NOOSHIN
Middle Name:
Last Name:HOSSEINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 BROADWAY SUITE 2750
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10279
Mailing Address - Country:US
Mailing Address - Phone:212-889-5544
Mailing Address - Fax:
Practice Address - Street 1:233 BROADWAY RM 2750
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10279-2704
Practice Address - Country:US
Practice Address - Phone:212-889-5544
Practice Address - Fax:212-481-1089
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10753300207RG0100X
MA248447207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology