Provider Demographics
NPI:1619123460
Name:ALIABADI, NEGAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NEGAR
Middle Name:
Last Name:ALIABADI
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 1:315 W 91ST ST
Mailing Address - Street 2:APT 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1039
Mailing Address - Country:US
Mailing Address - Phone:617-694-9831
Mailing Address - Fax:
Practice Address - Street 1:315 W 91ST ST
Practice Address - Street 2:APT 5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1039
Practice Address - Country:US
Practice Address - Phone:617-694-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY251351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program