Provider Demographics
NPI:1245397520
Name:NASSERI CLINIC OF ARTHRITIC AND RHEUMATIC DISEASES LLC
Entity Type:Organization
Organization Name:NASSERI CLINIC OF ARTHRITIC AND RHEUMATIC DISEASES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-744-0661
Mailing Address - Street 1:4 E ROLLING CROSSROADS STE 110
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 E ROLLING CROSSROADS STE 110
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6277
Practice Address - Country:US
Practice Address - Phone:410-744-0661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060914174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD902MMedicare ID - Type Unspecified
MDI09437Medicare UPIN