Provider Demographics
NPI:1174645857
Name:SABOURI, ABDOLNABI SASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDOLNABI
Middle Name:SASSAN
Last Name:SABOURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:99 NEEDHAM ST
Mailing Address - Street 2:APT#1101
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1632
Mailing Address - Country:US
Mailing Address - Phone:617-775-3260
Mailing Address - Fax:716-916-5783
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRAY-BIGELOW 444
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3030
Practice Address - Fax:617-726-3032
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT187998208600000X
NY390200000X
MA246250207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program