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Individual

DR. MANSOOR M NASIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
270-05 76TH AVE, B68, NEW HYDE PARK, NY 11040-1402
(718) 470-7490
(718) 347-9171
Mailing address
270-05 76TH AVE, B68, NEW HYDE PARK, NY 11040-1402
(718) 470-7490
(718) 347-9171

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
236585
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD035352
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010197171
VA
05
037027800
DC
05
408656200
MD
Enumeration date
08/21/2006
Last updated
12/10/2008
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