1962425330 NPI number — DR. NABEELA Z MIAN MD

Table of content: DR. NABEELA Z MIAN MD (NPI 1962425330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962425330 NPI number — DR. NABEELA Z MIAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIAN
Provider First Name:
NABEELA
Provider Middle Name:
Z
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962425330
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
419 BLACK WALNUT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNTAIN TOP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18707-1566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-403-5446
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1111 EAST END BLVD
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
WILKES-BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-3521
Provider Business Practice Location Address Fax Number:
570-821-7255
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  MD060483L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MD060483L . This is a "MEDICAL DOCTOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com