Provider Demographics
NPI:1093098022
Name:SABA MEDICAL PC
Entity Type:Organization
Organization Name:SABA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOLAHRARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-547-5614
Mailing Address - Street 1:PO BOX 1785
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-0906
Mailing Address - Country:US
Mailing Address - Phone:631-271-9151
Mailing Address - Fax:631-271-9155
Practice Address - Street 1:845 PALMER AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2406
Practice Address - Country:US
Practice Address - Phone:631-271-9151
Practice Address - Fax:631-271-9155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251481207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY251481OtherLICENSE