Provider Demographics
NPI:1548610728
Name:ANSARI, NUSRAT (LPN)
Entity Type:Individual
Prefix:MRS
First Name:NUSRAT
Middle Name:
Last Name:ANSARI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ACADAMY ROAD
Mailing Address - Street 2:PARSONS CHILD AND FAMILY CENTER
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-426-2817
Mailing Address - Fax:
Practice Address - Street 1:60 ACADAMY ROAD PARSONS CHILD AND FAMILY CENTER
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-426-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299934164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse