Provider Demographics
NPI:1750825840
Name:HEBRONI-YAGHOUBI, NOSHIEN
Entity Type:Individual
Prefix:
First Name:NOSHIEN
Middle Name:
Last Name:HEBRONI-YAGHOUBI
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 1:6 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1137
Mailing Address - Country:US
Mailing Address - Phone:516-242-8564
Mailing Address - Fax:
Practice Address - Street 1:6 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1137
Practice Address - Country:US
Practice Address - Phone:516-242-8564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020665-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist