Provider Demographics
NPI:1891409652
Name:ABBASIFARD, SALMAN (MD)
Entity Type:Individual
Prefix:
First Name:SALMAN
Middle Name:
Last Name:ABBASIFARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-5810
Mailing Address - Country:US
Mailing Address - Phone:718-960-1216
Mailing Address - Fax:718-579-2644
Practice Address - Street 1:1645 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5810
Practice Address - Country:US
Practice Address - Phone:718-960-1216
Practice Address - Fax:718-579-2644
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP118883390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program