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General NPI Number Information
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NPI Number | 1811653660
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Entity Type | Organization
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Legal Business Name | MAB INDUSTRIES LLC
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 89 HENDRICKSON AVE
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City | ELMONT
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State | NY
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Zip | 11003-1205
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Country | US
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Telephone | 917-582-7968
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Fax |
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Provider Business Mailing Address
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Address Line | 89 HENDRICKSON AVE
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City | ELMONT
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State | NY
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Zip | 11003-1205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMAD BABAR
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Credential |
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Telephone | 917-582-7968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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