Provider Demographics
NPI:1669218772
Name:ANVARIPOUR, AYLI SADAT (MD)
Entity type:Individual
Prefix:DR
First Name:AYLI
Middle Name:SADAT
Last Name:ANVARIPOUR
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 1:10677 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8760
Mailing Address - Country:US
Mailing Address - Phone:812-629-1937
Mailing Address - Fax:
Practice Address - Street 1:10677 WILLIAMSBURG DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8760
Practice Address - Country:US
Practice Address - Phone:812-629-1937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program