Healthcare Provider Details

I. General information

NPI: 1386654051
Provider Name (Legal Business Name): ASHRAF SABAHAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 STEUBEN ST
MONTOUR FALLS NY
14865
US

IV. Provider business mailing address

220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-8626
  • Fax: 607-210-1983
Mailing address:
  • Phone: 607-535-8626
  • Fax: 607-210-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number226187
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number226187
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number0101265041
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number226187
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: