Healthcare Provider Details

I. General information

NPI: 1003746389
Provider Name (Legal Business Name): ULIANOOR NOORZAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 LUCY LN
WAYNESBORO VA
22980-3275
US

IV. Provider business mailing address

116 LUCY LN
WAYNESBORO VA
22980-3275
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-2511
  • Fax:
Mailing address:
  • Phone: 540-932-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202223407
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: