Healthcare Provider Details

I. General information

NPI: 1730418625
Provider Name (Legal Business Name): TABASSUM A SABZWARI D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 HOBART ST
PERTH AMBOY NJ
08861
US

IV. Provider business mailing address

275 HOBART ST
PERTH AMBOY NJ
08861-3396
US

V. Phone/Fax

Practice location:
  • Phone: 732-376-9333
  • Fax:
Mailing address:
  • Phone: 732-376-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MB08754700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: