Provider Demographics
NPI:1477296325
Name:ABRISHAMCHI, AURASH DAVID
Entity Type:Individual
Prefix:
First Name:AURASH
Middle Name:DAVID
Last Name:ABRISHAMCHI
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 1:27 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1319
Mailing Address - Country:US
Mailing Address - Phone:516-587-4647
Mailing Address - Fax:
Practice Address - Street 1:2495 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4929
Practice Address - Country:US
Practice Address - Phone:716-839-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program