Basic Information
| Provider Information | |||||||||
| NPI: | 1386808210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IQBAL | ||||||||
| FirstName: | NOREEN | ||||||||
| MiddleName: | IMRAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ASGHAR | ||||||||
| OtherFirstName: | NOREEN | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MBBS | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10010K SHOPS WAY | ||||||||
| Address2: | |||||||||
| City: | NORTHBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015324137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0835376005 | ||||||||
| FaxNumber: | 5089196588 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 LIBERTY ST | ||||||||
| Address2: | |||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023015674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088940400 | ||||||||
| FaxNumber: | 5088940332 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2008 | ||||||||
| LastUpdateDate: | 08/21/2019 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 116020698 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 147731 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 247233 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.