Healthcare Provider Details

I. General information

NPI: 1871086835
Provider Name (Legal Business Name): SABA QADIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 HARRISBURG PIKE STE 312
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

28 CROSSING DR
LINWOOD NJ
08221-1945
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3022
  • Fax: 717-544-3021
Mailing address:
  • Phone: 609-457-1143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT215214
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMT215214
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: