Provider Demographics
NPI:1881579787
Name:NOORZAI, LUTFULLAH
Entity type:Individual
Prefix:
First Name:LUTFULLAH
Middle Name:
Last Name:NOORZAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1772
Mailing Address - Country:US
Mailing Address - Phone:227-249-4464
Mailing Address - Fax:
Practice Address - Street 1:7940 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:GLENARDEN
Practice Address - State:MD
Practice Address - Zip Code:20706-1772
Practice Address - Country:US
Practice Address - Phone:227-249-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABACB1338345106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician