Provider Demographics
NPI:1801597752
Name:MARJI, NOOR
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:MARJI
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 1:98 PARK HILL AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-8830
Mailing Address - Country:US
Mailing Address - Phone:310-531-6052
Mailing Address - Fax:
Practice Address - Street 1:98 PARK HILL AVE APT 2
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-8830
Practice Address - Country:US
Practice Address - Phone:310-531-6052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029583363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant