Provider Demographics
NPI:1922084441
Name:BRINSTER, NOOSHIN KETABCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:NOOSHIN
Middle Name:KETABCHI
Last Name:BRINSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 WHITE PLAINS RD FL 6
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5155
Mailing Address - Country:US
Mailing Address - Phone:914-345-1100
Mailing Address - Fax:914-345-1101
Practice Address - Street 1:560 WHITE PLAINS RD FL 6
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5155
Practice Address - Country:US
Practice Address - Phone:914-345-1100
Practice Address - Fax:914-345-1101
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216498207N00000X, 207ND0900X
VA0101239978207ND0900X
NY2126279207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA034279LGVMedicare ID - Type Unspecified
MAH09019Medicare UPIN