Provider Demographics
NPI:1578719944
Name:MAHMOOD, AFSAR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AFSAR
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MALCOLM AVE
Mailing Address - Street 2:
Mailing Address - City:TETERBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07608-1011
Mailing Address - Country:US
Mailing Address - Phone:201-393-5698
Mailing Address - Fax:
Practice Address - Street 1:1 MALCOLM AVE
Practice Address - Street 2:
Practice Address - City:TETERBORO
Practice Address - State:NJ
Practice Address - Zip Code:07608-1011
Practice Address - Country:US
Practice Address - Phone:201-393-5698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-17
Last Update Date:2008-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06440000207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology