MEDICARE: PA INSTITUTE OF NEUROLOGICAL DISORDER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	MD039921Y	PA
2	2084N0600X	Clinical Neurophysiology Physician	MD039921Y	PA
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	2084N0400X	Neurology Physician	MD039921Y	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000CM6837	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	205802	OTHER		BLACKLUNG
3	ME93711	OTHER	FL	FL LICENSE
4	0015096800004	OTHER		PA MEDICAL ASSISTANCE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4397783	OTHER	PA	AETNA
7	7991260	OTHER		GATEWAY
8	991260	OTHER		KEYSTONE
9	1905677	OTHER	PA	PA BLUE SHIELD
10	02301600	OTHER		CAPITAL BLUE CROSS
11	MD039921Y	OTHER	PA	PA LICENSE
12	T05677	OTHER	PA	AMERIHEALTH

General Provider Information

NPI Number	:	1326049388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PA INSTITUTE OF NEUROLOGICAL DISORDER PC

Provider Business Mailing Address
First Line	:	512 MARKET ST
Second Line	:
City	:	SUNBURY
State	:	PA
Zip	:	17801-2338
Country	:	US
Telephone Number	:	570-286-9878
Fax Number	:	570-286-9848

Provider Business Practice Location Address
First Line	:	512 MARKET ST
Second Line	:
City	:	SUNBURY
State	:	PA
Zip	:	17801-2338
Country	:	US
Telephone Number	:	570-286-9878
Fax Number	:	570-286-9848

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAHMOOD NASIR
Credential	:	MD
Telephone Number	:	570-286-9878

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	03/07/2023

Similar Medicare Providers

1497738934 — MAHMOOD NASIR MD
Practice Location Address:

512 MARKET ST
SUNBURY, PA
17801-2338

Practice Phone: 570-286-9878
Practice Fax: 570-286-9848

1437571791 — EMILY ANN HAAS CRNP
Practice Location Address:

1072 MARKET ST
SUNBURY, PA
17801-2458

Practice Phone: 570-286-8521
Practice Fax: 570-286-6197

1396730420 — ANTHONY CHARLES CATALANO MD
Practice Location Address:

300 WASHINGTON AVE
SUNBURY, PA
17801-1640

Practice Phone: 570-286-3584
Practice Fax: 570-286-3587

1578559670 — JESSICA BARBARA PAGANA-DEFAZIO DO
Practice Location Address:

1072 MARKET ST
SUNBURY, PA
17801-2458

Practice Phone: 570-286-8521
Practice Fax: 570-286-6197

1881680817 — DR. JOHN PATRICK PAGANA M.D.
Practice Location Address:

1072 MARKET ST
SUNBURY, PA
17801-2403

Practice Phone: 570-286-8521
Practice Fax: 570-286-6197

1740262971 — ANTONIO BUENDIA MD
Practice Location Address:

350 N 11TH ST
SUNBURY, PA
17801-1611

Practice Phone: 570-286-3472
Practice Fax: 570-286-3397

Directions to “PA INSTITUTE OF NEUROLOGICAL DISORDER PC ” Practice Location

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