Provider Demographics
NPI:1740635408
Name:NOURISHAD, ALEX ARASH (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:ARASH
Last Name:NOURISHAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W 18TH ST UNIT 1690
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10113-9666
Mailing Address - Country:US
Mailing Address - Phone:929-925-7797
Mailing Address - Fax:929-299-1663
Practice Address - Street 1:155 W 20TH ST APT 3D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3631
Practice Address - Country:US
Practice Address - Phone:929-925-7797
Practice Address - Fax:929-299-1663
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2951242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry