Healthcare Provider Details

I. General information

NPI: 1538802004
Provider Name (Legal Business Name): NOORUDDIN SYED HASHMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PATERSON ST FL 5
NEW BRUNSWICK NJ
08901-1962
US

IV. Provider business mailing address

1000 VERMELLA DR UNIT 561
NEW BRUNSWICK NJ
08901-5317
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-7840
  • Fax:
Mailing address:
  • Phone: 732-535-2937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1002X
TaxonomyPhysician Nutrition Specialist (Internal Medicine)
License Number25MA12605900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: