Provider Demographics
NPI:1497945844
Name:GHASSEMI, AKHTAR (RN)
Entity Type:Individual
Prefix:
First Name:AKHTAR
Middle Name:
Last Name:GHASSEMI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 WINTERBERRY CT
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:NY
Mailing Address - Zip Code:14568-9520
Mailing Address - Country:US
Mailing Address - Phone:315-986-9614
Mailing Address - Fax:
Practice Address - Street 1:1560 WINTERBERRY CT
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:NY
Practice Address - Zip Code:14568-9520
Practice Address - Country:US
Practice Address - Phone:315-986-9614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526424163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse