Healthcare Provider Details

I. General information

NPI: 1467171124
Provider Name (Legal Business Name): AMINE NASRI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

2929 WALNUT ST APT 4311
PHILADELPHIA PA
19104-5095
US

V. Phone/Fax

Practice location:
  • Phone: 888-369-2427
  • Fax:
Mailing address:
  • Phone: 514-229-7697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number330050
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number225398
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: