Healthcare Provider Details

I. General information

NPI: 1194749606
Provider Name (Legal Business Name): SUBHADRA L NORI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164TH ST QUEENS HOSPITAL CENTER
JAMAICA NY
11432-1121
US

IV. Provider business mailing address

27 CORNCRIB LANE
ROSLYN HEIGHTS NY
11577
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-4313
  • Fax: 718-883-6342
Mailing address:
  • Phone: 914-954-0503
  • Fax: 718-883-6342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberNY148791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: