Provider Demographics
NPI:1760834659
Name:NOOR, WAQQAS JALIL (MD, FRCSC)
Entity Type:Individual
Prefix:DR
First Name:WAQQAS
Middle Name:JALIL
Last Name:NOOR
Suffix:
Gender:M
Credentials:MD, FRCSC
Other - Prefix:DR
Other - First Name:WAQQAS
Other - Middle Name:NOOR
Other - Last Name:JALIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, FRCSC
Mailing Address - Street 1:1161 YORK AVE
Mailing Address - Street 2:9I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7940
Mailing Address - Country:US
Mailing Address - Phone:917-741-3848
Mailing Address - Fax:
Practice Address - Street 1:1161 YORK AVE
Practice Address - Street 2:9I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7940
Practice Address - Country:US
Practice Address - Phone:917-741-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP02520208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery