Provider Demographics
NPI:1609511542
Name:NOORI, SHAHIEN (PA)
Entity Type:Individual
Prefix:MR
First Name:SHAHIEN
Middle Name:
Last Name:NOORI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2309
Mailing Address - Country:US
Mailing Address - Phone:917-545-5340
Mailing Address - Fax:
Practice Address - Street 1:435 GREEN AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2309
Practice Address - Country:US
Practice Address - Phone:917-545-5340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program