Provider Demographics
NPI:1992744304
Name:PIRACHA, NISAR A (MD)
Entity type:Individual
Prefix:DR
First Name:NISAR
Middle Name:A
Last Name:PIRACHA
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 1:2332 SHELDON DR
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9440
Mailing Address - Country:US
Mailing Address - Phone:716-373-2729
Mailing Address - Fax:
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1025
Practice Address - Country:US
Practice Address - Phone:585-786-8940
Practice Address - Fax:585-786-1241
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173856-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD92222Medicare UPIN