Provider Demographics
NPI:1518230325
Name:MAHMOUD, SAHAR F (OD)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:F
Last Name:MAHMOUD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 VESTAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2300
Mailing Address - Country:US
Mailing Address - Phone:607-729-1212
Mailing Address - Fax:
Practice Address - Street 1:3900 VESTAL PARKWAY EAST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-729-1212
Practice Address - Fax:607-729-2605
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007806152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist