MEDICARE: OPHIR JEWEL SABAH

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	2086S0127X	Trauma Surgery Physician	25MP01001800	NJ

General Provider Information

NPI Number	:	1679428163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OPHIR JEWEL SABAH

Provider Business Mailing Address
First Line	:	309 ROSELLE AVE
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1412
Country	:	US
Telephone Number	:	516-557-6592
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 NJ-33
Second Line	:
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07753
Country	:	US
Telephone Number	:	732-775-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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