Healthcare Provider Details

I. General information

NPI: 1578869319
Provider Name (Legal Business Name): AMIR MARASHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3047 BRIGHTON 6TH ST STE 1
BROOKLYN NY
11235-6534
US

IV. Provider business mailing address

3047 BRIGHTON 6TH ST STE 1
BROOKLYN NY
11235-6534
US

V. Phone/Fax

Practice location:
  • Phone: 718-743-7877
  • Fax: 718-743-4870
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number262807
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: