Healthcare Provider Details

I. General information

NPI: 1609290949
Provider Name (Legal Business Name): SADAT ABIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 RIMROCK RD APT 102
FITCHBURG WI
53713-2709
US

IV. Provider business mailing address

1320 MENDOTA ST
MADISON WI
53714-1096
US

V. Phone/Fax

Practice location:
  • Phone: 608-467-2331
  • Fax: 608-284-7947
Mailing address:
  • Phone: 608-280-3180
  • Fax: 608-280-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5311-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: