Provider Demographics
NPI:1255398657
Name:ROOMI, NOOR A (MD)
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:A
Last Name:ROOMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NOOR
Other - Middle Name:A
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:330 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2129
Mailing Address - Country:US
Mailing Address - Phone:978-287-9350
Mailing Address - Fax:978-287-9421
Practice Address - Street 1:330 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2129
Practice Address - Country:US
Practice Address - Phone:978-287-9350
Practice Address - Fax:978-287-9421
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ23849OtherBLUE CROSS
MA0152871Medicaid
MA205853OtherTUFTS
MAHV0046OtherHARVARD PILGRIM
MAB10518201OtherCIGNA
MA7533265OtherAETNA
MA205853OtherTUFTS
MAH46008Medicare UPIN