Provider Demographics
NPI:1063443513
Name:MAHMOOD, NASIR (RPH)
Entity Type:Individual
Prefix:MR
First Name:NASIR
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:PINE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12567-0485
Mailing Address - Country:US
Mailing Address - Phone:518-398-5588
Mailing Address - Fax:518-398-7588
Practice Address - Street 1:2965 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-0339
Practice Address - Country:US
Practice Address - Phone:518-398-5588
Practice Address - Fax:518-398-7588
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist