Provider Demographics
NPI:1215947395
Name:BABAI, MASSOOD R (MD)
Entity type:Individual
Prefix:
First Name:MASSOOD
Middle Name:R
Last Name:BABAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 GRAHAM RD
Mailing Address - Street 2:#8
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2259
Mailing Address - Country:US
Mailing Address - Phone:330-929-8631
Mailing Address - Fax:330-929-1686
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:#8
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2259
Practice Address - Country:US
Practice Address - Phone:330-929-8631
Practice Address - Fax:330-929-1686
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034523B2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35034523BMedicaid
BA0402983Medicare ID - Type Unspecified
OH35034523BMedicaid