Provider Demographics
NPI:1023540606
Name:MB-SC INC
Entity Type:Organization
Organization Name:MB-SC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:OMER
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-627-9987
Mailing Address - Street 1:146 AUTUMN CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6574
Mailing Address - Country:US
Mailing Address - Phone:631-627-9987
Mailing Address - Fax:
Practice Address - Street 1:146 AUTUMN CHASE DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-6574
Practice Address - Country:US
Practice Address - Phone:631-627-9987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247070207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty