Active NPI
Naeem Amanullah Pathan, M.D.
- Geriatric Psychiatry Physician
- Phoenix, AZ
National Provider Identifier
1366506263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 17016
- Practice address
- 3450 N 3Rd St
Phoenix, AZ 85012-2331 - Phone
- (602) 265-8338
- Fax
- (602) 265-8377
- NPI assigned
- Dec 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | 17016 | AZ | Primary |
Addresses
Primary practice location
3450 N 3Rd St
Phoenix, AZ 85012-2331
Mailing address
12145 East Lupine Ave,
Scottsdale, AZ 85259
Phone (480) 474-4779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221696000000",
"number": "1366506263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12145 EAST LUPINE AVE,",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85259",
"telephone_number": "480-474-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 N 3RD ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122331",
"telephone_number": "602-265-8338",
"fax_number": "602-265-8377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHAN",
"first_name": "NAEEM",
"middle_name": "AMANULLAH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2008-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "AZ",
"license": "17016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.