Provider Demographics
NPI:1750817086
Name:HOURIEH, NASER
Entity Type:Individual
Prefix:DR
First Name:NASER
Middle Name:
Last Name:HOURIEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3084 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2601
Mailing Address - Country:US
Mailing Address - Phone:917-209-7321
Mailing Address - Fax:
Practice Address - Street 1:3084 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2601
Practice Address - Country:US
Practice Address - Phone:917-209-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2591871103TS0200X
390200000X
NY023936103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program