Provider Demographics
NPI:1235243536
Name:MAHBOOB, SABRINA (M D)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:
Last Name:MAHBOOB
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 MALCOLM X BLVD
Mailing Address - Street 2:WP 522
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-2740
Mailing Address - Fax:212-939-2759
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:WP 522
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-2740
Practice Address - Fax:212-939-2759
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2345662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000120775OtherGHI HMO
NY059XE1OtherEMPIRE BCBS
NY107205805OtherDOL
NY059XF2OtherEMPIRE BCBS
NY08453565OtherCARECORE PPO
NY107205801OtherDOL
NY059XE3OtherEMPIRE BCBS
NY107205800OtherDOL
NY234566OtherHIP/VYTRA
NY771894OtherUHC
NY02827829Medicaid
NY0177310OtherGHI PPO
NY0459214OtherCARECORE HMO
NY059XF1OtherEMPIRE BCBS
NY059XE2OtherEMPIRE BCBS
NY059XE1OtherEMPIRE BCBS
NY059XE2OtherEMPIRE BCBS
NY059XF2OtherEMPIRE BCBS