Provider Demographics
NPI:1568130078
Name:NOORANI, CYNTHIA (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:NOORANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EXECUTIVE PARK WEST NE UNIT 554
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2286
Mailing Address - Country:US
Mailing Address - Phone:561-602-0179
Mailing Address - Fax:
Practice Address - Street 1:4800 BRIARCLIFF RD NE # 1173
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2743
Practice Address - Country:US
Practice Address - Phone:770-727-0772
Practice Address - Fax:770-766-1117
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003369152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist