Healthcare Provider Details

I. General information

NPI: 1992744304
Provider Name (Legal Business Name): NISAR A PIRACHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAIN ST
WARSAW NY
14569-1025
US

IV. Provider business mailing address

2332 SHELDON DR
ALLEGANY NY
14706-9440
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8940
  • Fax: 585-786-1241
Mailing address:
  • Phone: 716-373-2729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number173856-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: