Basic Information
| Provider Information | |||||||||
| NPI: | 1447341318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASEEM | ||||||||
| FirstName: | PARVAIZ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 WALTON ST | ||||||||
| Address2: | APT # 302 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132021248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154224350 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 PROSPECT AVE | ||||||||
| Address2: | ST. JOSEPH HOSPITAL HEALTH CENTER | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132031807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154485704 | ||||||||
| FaxNumber: | 3154236853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 117709 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00373006 | 05 | NY | MEDICAID |