Provider Demographics
NPI:1013138874
Name:AKHAVAN, ARASH (MD, FAAD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:AKHAVAN
Suffix:
Gender:M
Credentials:MD, FAAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 57TH ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3211
Mailing Address - Country:US
Mailing Address - Phone:212-444-8204
Mailing Address - Fax:
Practice Address - Street 1:200 W 57TH ST
Practice Address - Street 2:SUITE 510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:212-444-8204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233858207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0230373OtherGHI PPO (ORANGEBURG, NY)
NYP3827686OtherOXFORD
NY4K4531OtherBLUE CROSS/BLUE SHIELD (ORANGEBURG, NY)
NY2789991OtherUNITED HEALTH CARE
NY0531443OtherCIGNA
NY1573559OtherAETNA HMO
NY7214962OtherAETNA PPO
NY0165304OtherGHI PPO (NEW YORK, NY)
NY4K1991OtherBLUE CROSS/BLUE SHIELD (NEW YORK, NY)
NY0119859OtherGHI HMO