Healthcare Provider Details
I. General information
NPI: 1770675910
Provider Name (Legal Business Name): NARGIS J MINHAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2123 RIVER ROAD
NISKAYUNA NY
12309
US
IV. Provider business mailing address
PO BOX 11-719
ALBANY NY
12211
US
V. Phone/Fax
- Phone: 518-428-8708
- Fax:
- Phone: 518-428-8708
- Fax: 518-389-1788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 199913 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: