Provider Demographics
NPI:1083852859
Name:SABUROVA, NATALYA (MD)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:SABUROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3300
Mailing Address - Country:US
Mailing Address - Phone:908-436-1002
Mailing Address - Fax:908-436-1109
Practice Address - Street 1:433 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3300
Practice Address - Country:US
Practice Address - Phone:908-436-1002
Practice Address - Fax:908-436-1109
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
NJ25MA11104000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program