Provider Demographics
NPI:1043506231
Name:NOOR, EMAD ROSHDY
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:ROSHDY
Last Name:NOOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:EMAD
Other - Middle Name:ROSHDY ABDELNOOR
Other - Last Name:KOUSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:65 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3947
Mailing Address - Country:US
Mailing Address - Phone:732-321-7010
Mailing Address - Fax:732-744-5873
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3947
Practice Address - Country:US
Practice Address - Phone:732-321-7010
Practice Address - Fax:732-744-5873
Is Sole Proprietor?:No
Enumeration Date:2011-06-25
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA098007002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0513946Medicaid
NJ0513946Medicaid