Provider Demographics
NPI:1003099474
Name:WEBSTER PSYCHIATRY & MEDICINE, PLLC
Entity Type:Organization
Organization Name:WEBSTER PSYCHIATRY & MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEZABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-670-0507
Mailing Address - Street 1:1527 EMPIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2103
Mailing Address - Country:US
Mailing Address - Phone:585-670-0507
Mailing Address - Fax:585-645-0939
Practice Address - Street 1:1527 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2103
Practice Address - Country:US
Practice Address - Phone:585-670-0507
Practice Address - Fax:585-645-0939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225834207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA1344Medicare PIN