Provider Demographics
NPI:1578153722
Name:ALEX NOURISHAD MD PC
Entity Type:Organization
Organization Name:ALEX NOURISHAD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURISHAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:929-925-7797
Mailing Address - Street 1:217 W 18TH ST UNIT 1690
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10113-1838
Mailing Address - Country:US
Mailing Address - Phone:929-925-7797
Mailing Address - Fax:929-299-1663
Practice Address - Street 1:217 W 18TH ST UNIT 1690
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10113-1838
Practice Address - Country:US
Practice Address - Phone:929-925-7797
Practice Address - Fax:929-299-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty