Provider Demographics
NPI:1669611844
Name:ACRISH, ALBERT (ANP)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:ACRISH
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3537
Mailing Address - Country:US
Mailing Address - Phone:845-451-1234
Mailing Address - Fax:845-905-4061
Practice Address - Street 1:364 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-3537
Practice Address - Country:US
Practice Address - Phone:845-451-1234
Practice Address - Fax:845-905-4061
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300143-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health