Basic Information
Provider Information
NPI: 1609989136
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYED
FirstName: TASNEEM
MiddleName: A
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 E NORTH AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124756
CountryCode: US
TelephoneNumber: 4123596886
FaxNumber: 4123593598
Practice Location
Address1: 100 MEDICAL BLVD
Address2:  
City: CANONSBURG
State: PA
PostalCode: 153179762
CountryCode: US
TelephoneNumber: 7247453916
FaxNumber: 7247466328
Other Information
ProviderEnumerationDate: 08/17/2006
LastUpdateDate: 10/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XMD017731YPAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
000934607000205PA MEDICAID


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