Provider Demographics
NPI:1164610820
Name:SOBHANI-MAHDABI, AREF (MD)
Entity Type:Individual
Prefix:
First Name:AREF
Middle Name:
Last Name:SOBHANI-MAHDABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 DENISON PKWY E
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2814
Mailing Address - Country:US
Mailing Address - Phone:347-565-9949
Mailing Address - Fax:
Practice Address - Street 1:176 DENISON PKWY E
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2814
Practice Address - Country:US
Practice Address - Phone:347-565-9949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255819208M00000X
WI50884-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist