Provider Demographics
NPI:1679004089
Name:NASSAR, AMRO ALY (MD)
Entity Type:Individual
Prefix:DR
First Name:AMRO
Middle Name:ALY
Last Name:NASSAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WESTAGE BUSINESS CTR DR STE 209
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2295
Mailing Address - Country:US
Mailing Address - Phone:845-896-0736
Mailing Address - Fax:
Practice Address - Street 1:400 WESTAGE BUSINESS CTR DR STE 209
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2295
Practice Address - Country:US
Practice Address - Phone:845-896-0736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317521-01207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology