Provider Demographics
NPI:1992409817
Name:NOORI, IMAN TAHA
Entity type:Individual
Prefix:
First Name:IMAN
Middle Name:TAHA
Last Name:NOORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 ASSHAN ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-9013
Mailing Address - Country:US
Mailing Address - Phone:330-361-1429
Mailing Address - Fax:
Practice Address - Street 1:3737ASSHAN CIRCLE ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4472
Practice Address - Country:US
Practice Address - Phone:330-361-1429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide