Basic Information
| Provider Information | |||||||||
| NPI: | 1407292741 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASGHAR | ||||||||
| FirstName: | IRFAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.D.S, M.D.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 BROADWAY | ||||||||
| Address2: | SUITE #105 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100073001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123749500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 225 BROADWAY | ||||||||
| Address2: | SUITE #105 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100073001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123749500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2013 | ||||||||
| LastUpdateDate: | 10/24/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223E0200X | 0401413977 | VA | N | Dental Providers | Dentist | Endodontics | 1223E0200X | 058389-1 | NY | Y | Dental Providers | Dentist | Endodontics |
No ID Information.