Healthcare Provider Details

I. General information

NPI: 1811672058
Provider Name (Legal Business Name): ALBERT SABIROV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HAGEN DR STE 300
ROCHESTER NY
14625-2658
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-0150
  • Fax: 585-586-9108
Mailing address:
  • Phone:
  • Fax: 585-922-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number345725
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: