Provider Demographics
NPI:1285297580
Name:POURAFKARI, LEILI
Entity type:Individual
Prefix:DR
First Name:LEILI
Middle Name:
Last Name:POURAFKARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JEWETT PKWY APT O
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2360
Mailing Address - Country:US
Mailing Address - Phone:716-345-4976
Mailing Address - Fax:
Practice Address - Street 1:144 GENESEE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1560
Practice Address - Country:US
Practice Address - Phone:716-706-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program