Provider Demographics
NPI:1679203772
Name:AGHAYAN, NASIM (DC)
Entity Type:Individual
Prefix:
First Name:NASIM
Middle Name:
Last Name:AGHAYAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:NASIM
Other - Middle Name:
Other - Last Name:AGHAYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:280 MADISON AVE RM 800
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0824
Mailing Address - Country:US
Mailing Address - Phone:347-607-7190
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE RM 800
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0824
Practice Address - Country:US
Practice Address - Phone:347-607-7190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX013360OtherCHIROPRACTOR