Healthcare Provider Details

I. General information

NPI: 1154996197
Provider Name (Legal Business Name): SAHAARA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8107 ASTORIA BLVD
EAST ELMHURST NY
11370
US

IV. Provider business mailing address

2349 81ST ST
EAST ELMHURST NY
11370-1620
US

V. Phone/Fax

Practice location:
  • Phone: 646-386-6220
  • Fax: 917-832-6598
Mailing address:
  • Phone: 646-386-6220
  • Fax: 917-832-6598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TANZIA MUSTAFA
Title or Position: MD/OWNER
Credential: MD
Phone: 347-276-3801