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General NPI Number Information
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NPI Number | 1790063402
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Entity Type | Individual
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Provider Name | SONEA MAHBOOB MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2500 CASSADY AVE
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City | HUNTINGDON
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State | PA
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Zip | 16652-2674
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Country | US
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Telephone | 814-345-1901
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Fax |
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Provider Business Mailing Address
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Address Line | 40 PARSONS WAY
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City | AVON
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State | CT
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Zip | 06001-2539
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Country | US
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Telephone | 551-574-3004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 267882
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 69206
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License Number State | WI
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