NPI Code Details Logo

NPI 1053879379

NPI 1053879379 : AHMAD BASSEM NASHIF PA : LAWRENCEVILLE, NJ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1053879379
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    AHMAD BASSEM NASHIF PA
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/05/2019
-----------------------------------------------------
    Last Update Date     |    08/20/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4 PRINCESS RD STE 206 
-----------------------------------------------------
    City                 |    LAWRENCEVILLE
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    08648-2322
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    609-482-3701
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5 BRIANNA CT 
-----------------------------------------------------
    City                 |    HAMILTON
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    08619-1400
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    609-789-7385
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363AM0700X
-----------------------------------------------------
    Taxonomy Name        |    Medical Physician Assistant
-----------------------------------------------------
    License Number       |    25MP00515900
-----------------------------------------------------
    License Number State |    NJ
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.