Healthcare Provider Details

I. General information

NPI: 1841534724
Provider Name (Legal Business Name): NASEEM DEEN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9475 LANTERN BAY CIR
WEST PALM BEACH FL
33411-5170
US

IV. Provider business mailing address

9475 LANTERN BAY CIR
WEST PALM BEACH FL
33411-5170
US

V. Phone/Fax

Practice location:
  • Phone: 732-415-2060
  • Fax:
Mailing address:
  • Phone: 732-415-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number22096
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: