Organization
PA INSTITUTE OF NEUROLOGICAL DISORDER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHMOOD NASIR MD (PRESIDENT)
(570) 286-9878
Entity
Organization
Contact information
Practice address
512 MARKET ST, SUNBURY, PA 17801-2338
(570) 286-9878
(570) 286-9848
Mailing address
512 MARKET ST, SUNBURY, PA 17801-2338
(570) 286-9878
(570) 286-9848
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD039921Y
PA
2084N0600X
Clinical Neurophysiology Physician
MD039921Y
PA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
MD039921Y
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000CM6837
RAILROAD MEDICARE
PA
01
—
0015096800004
PA MEDICAL ASSISTANCE
—
05
—
0015096800004
—
PA
01
—
02301600
CAPITAL BLUE CROSS
—
01
—
1905677
PA BLUE SHIELD
PA
01
—
205802
BLACKLUNG
—
01
—
4397783
AETNA
PA
01
—
7991260
GATEWAY
—
01
—
991260
KEYSTONE
—
01
—
MD039921Y
PA LICENSE
PA
01
—
ME93711
FL LICENSE
FL
01
—
T05677
AMERIHEALTH
PA
Enumeration date
08/02/2005
Last updated
03/07/2023
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