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General NPI Number Information
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NPI Number | 1609601426
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Entity Type | Individual
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Provider Name | AHMAD NASASRA NASASRA MD
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Gender | Male
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | ONE GUSTAVE L. LEVY PLACE, BOX 1259, NEW YORK, NY 10029
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 212-241-8071
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Fax |
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Provider Business Mailing Address
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Address Line | ONE GUSTAVE L. LEVY PLACE, BOX 1259, NEW YORK, NY 10029
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City | NY
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State | NY
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Zip | 10029
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Country | US
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Telephone | 718-374-7842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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