Healthcare Provider Details

I. General information

NPI: 1164484788
Provider Name (Legal Business Name): GHOUSIA PARVEEN SYED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 WAYLAND SMITH DR
UNIONTOWN PA
15401-2677
US

IV. Provider business mailing address

140 WAYLAND SMITH DR
UNIONTOWN PA
15401-2677
US

V. Phone/Fax

Practice location:
  • Phone: 724-437-9854
  • Fax: 724-437-8305
Mailing address:
  • Phone: 724-437-9854
  • Fax: 724-437-8305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD059121L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: