Provider Demographics
NPI:1437112208
Name:MAHMOOD, SABAHAT (MD)
Entity Type:Individual
Prefix:DR
First Name:SABAHAT
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 DEER PARK RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5237
Mailing Address - Country:US
Mailing Address - Phone:631-271-3134
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS MEDICAL CENTER
Practice Address - Street 2:79 MIDDLEVILLE RD
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-774-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218340207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine