Healthcare Provider Details

I. General information

NPI: 1447231964
Provider Name (Legal Business Name): POUNE SABERI MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

IV. Provider business mailing address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5800
  • Fax: 215-823-5968
Mailing address:
  • Phone: 215-823-5800
  • Fax: 215-823-5968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD418711
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD418711
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: