Provider Demographics
NPI:1770831984
Name:MALIK, NASIR MEHMOOD (MD)
Entity type:Individual
Prefix:
First Name:NASIR
Middle Name:MEHMOOD
Last Name:MALIK
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 1:2113 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3403
Mailing Address - Country:US
Mailing Address - Phone:609-710-5526
Mailing Address - Fax:609-503-4194
Practice Address - Street 1:441 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2710
Practice Address - Country:US
Practice Address - Phone:609-710-5526
Practice Address - Fax:609-503-4194
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10702800207R00000X, 207RP1001X, 207RP1001X
PAMD468998207RP1001X, 207RP1001X
INCV2004917207RP1001X
NY271043208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03616795Medicaid
NY03616795Medicaid