MEDICARE: SEPIDEH NOORANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DS044088	PA

General Provider Information

NPI Number	:	1437734118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEPIDEH NOORANI

Provider Business Mailing Address
First Line	:	251 S OLDS BLVD APT 63
Second Line	:
City	:	FAIRLESS HILLS
State	:	PA
Zip	:	19030-3424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 WALNUT ST STE 402
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2903
Country	:	US
Telephone Number	:	215-972-0181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2021
Last Update Date	:	05/10/2024

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Directions to “ SEPIDEH NOORANI ” Practice Location

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