Provider Demographics
NPI:1134727407
Name:AKHLAGHI, MARIE JASMIN THERESIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE JASMIN
Middle Name:THERESIA
Last Name:AKHLAGHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:THERESIA
Other - Middle Name:
Other - Last Name:AKHLAGHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:564 1ST AVE APT 15L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6487
Mailing Address - Country:US
Mailing Address - Phone:109-178-0366
Mailing Address - Fax:
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program