MEDICARE: SAHAARA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1154996197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAHAARA, INC.

Provider Business Mailing Address
First Line	:	2349 81ST ST
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370-1620
Country	:	US
Telephone Number	:	646-386-6220
Fax Number	:	917-832-6598

Provider Business Practice Location Address
First Line	:	8107 ASTORIA BLVD
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370
Country	:	US
Telephone Number	:	646-386-6220
Fax Number	:	917-832-6598

Authorized Official
Title or Position	:	MD/OWNER
Name	:	TANZIA MUSTAFA
Credential	:	MD
Telephone Number	:	347-276-3801

Provider Enumeration Date	:	05/21/2021
Last Update Date	:	07/13/2021

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Directions to “SAHAARA, INC. ” Practice Location

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