Healthcare Provider Details

I. General information

NPI: 1386031565
Provider Name (Legal Business Name): NOOR AL-HUSAYNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

2556 82ND ST
EAST ELMHURST NY
11370-1629
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-5455
  • Fax:
Mailing address:
  • Phone: 917-945-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number294258
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MA11254900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: