Provider Demographics
NPI:1801387063
Name:MOHEB, NEGAR (MD)
Entity Type:Individual
Prefix:
First Name:NEGAR
Middle Name:
Last Name:MOHEB
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 1:45 N 6TH ST APT 487
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1104
Mailing Address - Country:US
Mailing Address - Phone:424-299-7299
Mailing Address - Fax:
Practice Address - Street 1:1250 S CEDAR CREST BLVD STE 405
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6224
Practice Address - Country:US
Practice Address - Phone:610-402-8420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71042207WX0109X
390200000X
PAMD4825672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program