Provider Demographics
NPI:1548431919
Name:NABAT MEDICAL PC
Entity Type:Organization
Organization Name:NABAT MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/M.D
Authorized Official - Prefix:
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFAELMEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-897-7430
Mailing Address - Street 1:135 GRISTMILL LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1836
Mailing Address - Country:US
Mailing Address - Phone:718-897-7430
Mailing Address - Fax:718-896-0062
Practice Address - Street 1:9712 63RD DR
Practice Address - Street 2:SUITE 1B
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2243
Practice Address - Country:US
Practice Address - Phone:718-897-7430
Practice Address - Fax:718-896-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01506858Medicaid
NYA100001433Medicare PIN
NY01506858Medicaid