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General NPI Number Information
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NPI Number | 1023612173
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Entity Type | Individual
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Provider Name | MAQSOOD NATHU PA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2020
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Last Update Date | 11/29/2020
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Provider Practice Location Address
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Address Line | 1026 W ELIZABETH AVE
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City | LINDEN
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State | NJ
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Zip | 07036-6341
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Country | US
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Telephone | 518-925-7577
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SADDLEBROOK DR
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City | CLIFTON PARK
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State | NY
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Zip | 12065-6795
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Country | US
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Telephone | 518-925-7577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | 000312
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License Number State | NY
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