Provider Demographics
NPI:1134692924
Name:MAHSA A SOHRAB MD PLLC
Entity Type:Organization
Organization Name:MAHSA A SOHRAB MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHSA
Authorized Official - Middle Name:AVA
Authorized Official - Last Name:SOHRAB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-340-1301
Mailing Address - Street 1:25 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5203
Mailing Address - Country:US
Mailing Address - Phone:203-340-1301
Mailing Address - Fax:442-223-0286
Practice Address - Street 1:25 VALLEY DR STE 2B
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5203
Practice Address - Country:US
Practice Address - Phone:203-340-1301
Practice Address - Fax:442-223-0286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty