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General NPI Number Information
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NPI Number | 1750784021
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Entity Type | Organization
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Legal Business Name | NABILA L SARGIOUS MD INC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 3755 S RACCOON RD
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City | CANFIELD
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State | OH
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Zip | 44406-9372
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Country | US
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Telephone | 330-793-5566
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Fax | 330-793-7646
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Provider Business Mailing Address
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Address Line | PO BOX 4294
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-0294
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Country | US
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Telephone | 330-793-5566
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Fax | 330-793-7646
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Authorized Official
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Title or Position | OWNER
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Name | NABILA L SARGIOUS
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Credential | MD
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Telephone | 330-518-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35079386
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License Number State | OH
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