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General NPI Number Information
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NPI Number | 1326049388
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Entity Type | Organization
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Legal Business Name | PA INSTITUTE OF NEUROLOGICAL DISORDER PC
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 512 MARKET ST
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City | SUNBURY
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State | PA
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Zip | 17801-2338
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Country | US
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Telephone | 570-286-9878
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Fax | 570-286-9848
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Provider Business Mailing Address
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Address Line | 512 MARKET ST
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City | SUNBURY
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State | PA
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Zip | 17801-2338
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Country | US
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Telephone | 570-286-9878
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Fax | 570-286-9848
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAHMOOD NASIR
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Credential | MD
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Telephone | 570-286-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | MD039921Y
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | MD039921Y
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD039921Y
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License Number State | PA
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