Provider Demographics
NPI:1740583723
Name:WAHAB, ARYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARYAN
Middle Name:
Last Name:WAHAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4361
Mailing Address - Country:US
Mailing Address - Phone:716-803-5657
Mailing Address - Fax:
Practice Address - Street 1:3 GATES CIRCLE, 9TH FLOOR
Practice Address - Street 2:MILLARD FILMORE GATES HOSPITAL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209
Practice Address - Country:US
Practice Address - Phone:716-887-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program