Provider Demographics
NPI:1134592512
Name:AKHROR, NILUFAR
Entity type:Individual
Prefix:
First Name:NILUFAR
Middle Name:
Last Name:AKHROR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MCKINLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4723
Mailing Address - Country:US
Mailing Address - Phone:917-443-3032
Mailing Address - Fax:
Practice Address - Street 1:259 MCKINLEY BLVD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4723
Practice Address - Country:US
Practice Address - Phone:917-443-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00623900367500000X
NJ26NR16927500163WC0200X
NY606779-1163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine