| Nazeeri Family Medicine | |
|
1023 Poplar St Lebanon PA 17042-6636 | |
| (717) 270-9446 | |
| (717) 270-5669 |
| Full Name | Nazeeri Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1023 Poplar St, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Sarah Margaret Nazeeri (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7172709446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nazeeri Family Medicine 1023 Poplar St Lebanon PA 17042-6636 Ph: (717) 270-9446 | Nazeeri Family Medicine 1023 Poplar St Lebanon PA 17042-6636 Ph: (717) 270-9446 |
| NPI Number | 1104948082 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 11/01/2022 |
| Medicare PECOS PAC ID | 6800062837 |
|---|---|
| Medicare Enrollment ID | O20111222000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104948082 | NPI | - | NPPES |
| 1038504970001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD071071-L (Pennsylvania) | Primary |
| Provider Name | Musaddiq N Nazeeri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952392441 PECOS PAC ID: 6709074750 Enrollment ID: I20101217000605 |
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