Provider Demographics
NPI:1548219181
Name:ELEZABI, SAHAR (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:ELEZABI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 EMPIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2103
Mailing Address - Country:US
Mailing Address - Phone:585-771-7570
Mailing Address - Fax:
Practice Address - Street 1:1527 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2103
Practice Address - Country:US
Practice Address - Phone:585-771-7570
Practice Address - Fax:585-645-0939
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83043207R00000X
NY2258342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB9693Medicare ID - Type UnspecifiedPROVIDER NO
NYH11667Medicare UPIN
CA00A830432Medicare ID - Type UnspecifiedPROVIDER NUMBER