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General NPI Number Information
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NPI Number | 1871674648
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Entity Type | Individual
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Provider Name | ABDOLLAH NABAVI MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 315 S ALLEN ST SUITE 223
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City | STATE COLLEGE
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State | PA
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Zip | 16801-4849
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Country | US
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Telephone | 814-237-5411
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Fax | 814-237-2656
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Provider Business Mailing Address
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Address Line | 315 S ALLEN ST SUITE 223
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City | STATE COLLEGE
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State | PA
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Zip | 16801-4849
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Country | US
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Telephone | 814-237-5411
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Fax | 814-237-2656
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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 | MD038134L
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License Number State | PA
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