Provider Demographics
NPI:1740876846
Name:DEMIRKAN, NILUFER (PA-S)
Entity type:Individual
Prefix:MRS
First Name:NILUFER
Middle Name:
Last Name:DEMIRKAN
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5430
Mailing Address - Country:US
Mailing Address - Phone:347-439-6480
Mailing Address - Fax:
Practice Address - Street 1:421 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5430
Practice Address - Country:US
Practice Address - Phone:347-439-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program