Provider Demographics
NPI:1740369776
Name:S&RSABAPC
Entity type:Organization
Organization Name:S&RSABAPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOUHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SABA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-772-8878
Mailing Address - Street 1:1300 MAIN AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2266
Mailing Address - Country:US
Mailing Address - Phone:973-772-8878
Mailing Address - Fax:973-772-8803
Practice Address - Street 1:1300 MAIN AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2266
Practice Address - Country:US
Practice Address - Phone:973-772-8878
Practice Address - Fax:973-772-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065307207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ868013OtherAETNA
NJ23759OtherAMERIGROUP
NJ7252404Medicaid
NJ1832012OtherUNITED HEALTH CARE
NJ1K2646OtherHEALTH NET
NJ875621OtherCIGNA
NJP867741OtherOXFORD
NJ23759OtherAMERIGROUP
NJ=========OtherBEECH STREET
NJ1K2646OtherHEALTH NET
NJ=========OtherMAGNA CARE
NJ=========OtherQUAL CARE
NJ903996Medicare PIN
NJ1K2646OtherHEALTH NET