Provider Demographics
NPI:1255693974
Name:AFSHARIAN, KOROSH
Entity Type:Individual
Prefix:MR
First Name:KOROSH
Middle Name:
Last Name:AFSHARIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BOULEVARD OF THE GENERALS
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3692
Mailing Address - Country:US
Mailing Address - Phone:610-539-5093
Mailing Address - Fax:610-539-5294
Practice Address - Street 1:2500 BOULEVARD OF THE GENERALS
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3692
Practice Address - Country:US
Practice Address - Phone:610-539-5093
Practice Address - Fax:610-539-5294
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040133L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist