Provider Demographics
NPI:1366681504
Name:NAZIR, KAUSAR (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUSAR
Middle Name:
Last Name:NAZIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAUSAR
Other - Middle Name:
Other - Last Name:SHEIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2650
Mailing Address - Country:US
Mailing Address - Phone:845-333-3370
Mailing Address - Fax:845-333-3372
Practice Address - Street 1:707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2650
Practice Address - Country:US
Practice Address - Phone:845-333-3370
Practice Address - Fax:845-333-3372
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287247207Q00000X, 208M00000X
NDTRL11118207Q00000X
MO2013025697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12083Medicaid
NY04698266Medicaid
NY04698266Medicaid