Healthcare Provider Details

I. General information

NPI: 1164628376
Provider Name (Legal Business Name): MUHAMMAD HASNAIN NOOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720, 175TH ST, APT 3A
JAMAICA NY
11432-5701
US

IV. Provider business mailing address

8720 175TH ST APT 3A
JAMAICA NY
11432-5701
US

V. Phone/Fax

Practice location:
  • Phone: 718-291-3062
  • Fax:
Mailing address:
  • Phone: 718-291-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number244672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: