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NPI Code Detail

MEDICARE: NIKTA SADAT ATHARI ANARAKI

MEDICARE: NIKTA SADAT ATHARI ANARAKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant028746NY

General Provider Information

NPI Number : 1669016614
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKTA SADAT ATHARI ANARAKI
Provider Business Mailing Address
First Line : 422 SAINT NICHOLAS AVE APT 2N
Second Line :
City : NEW YORK
State : NY
Zip : 10027-7683
Country : US
Telephone Number : 630-815-6490
Fax Number :
Provider Business Practice Location Address
First Line : 160 CONVENT AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10031-9198
Country : US
Telephone Number : 212-650-7745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2019
Last Update Date : 09/20/2022

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Directions to “ NIKTA SADAT ATHARI ANARAKI ” Practice Location

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