Provider Demographics
NPI:1710991120
Name:NUR, SAMINA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMINA
Middle Name:
Last Name:NUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SIENNA DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7164
Mailing Address - Country:US
Mailing Address - Phone:203-798-6446
Mailing Address - Fax:
Practice Address - Street 1:4 SKYLINE DRIVE
Practice Address - Street 2:UNIVERSITY PATHOLOGY, P.C.
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10504
Practice Address - Country:US
Practice Address - Phone:914-345-3315
Practice Address - Fax:914-345-3064
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002381174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY136655Medicare UPIN
NY58R031Medicare ID - Type Unspecified