Provider Demographics
NPI:1033119318
Name:NADEEM, ASIYA (MD)
Entity Type:Individual
Prefix:
First Name:ASIYA
Middle Name:
Last Name:NADEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1123
Mailing Address - Country:US
Mailing Address - Phone:717-232-9971
Mailing Address - Fax:717-920-3039
Practice Address - Street 1:110 S 17TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1123
Practice Address - Country:US
Practice Address - Phone:717-232-9971
Practice Address - Fax:717-920-3039
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250702208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103335662-0001Medicaid
AZ621236Medicaid