Healthcare Provider Details

I. General information

NPI: 1588051015
Provider Name (Legal Business Name): NOREEN HOSSAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 06/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 STONEWALL RD STE 1A
MANASSAS VA
20110-8327
US

IV. Provider business mailing address

8701 STONEWALL RD STE 1A
MANASSAS VA
20110-8327
US

V. Phone/Fax

Practice location:
  • Phone: 703-257-9878
  • Fax:
Mailing address:
  • Phone: 703-257-9878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101264922
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: