Provider Demographics
NPI:1609601426
Name:NASASRA, AHMAD NASASRA (MD)
Entity type:Individual
Prefix:MR
First Name:AHMAD
Middle Name:NASASRA
Last Name:NASASRA
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:ONE GUSTAVE L. LEVY PLACE, BOX 1259, NEW YORK, NY 10029
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:718-374-7842
Mailing Address - Fax:
Practice Address - Street 1:ONE GUSTAVE L. LEVY PLACE, BOX 1259, NEW YORK, NY 10029
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program