Healthcare Provider Details
I. General information
NPI: 1780493429
Provider Name (Legal Business Name): ARMAN MAQBOOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/07/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4461 STATE ROUTE 159 STE A
CHILLICOTHEE OH
45601-6000
US
IV. Provider business mailing address
51 FARRINGTON AVE
BAY SHORE NY
11706-3056
US
V. Phone/Fax
- Phone: 740-779-4900
- Fax: 740-779-4909
- Phone: 631-908-1120
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 57.260201 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | P133266 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: