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NPI Code Detail

MEDICARE: SABOOR WAIZUN MEDICAL PC

MEDICARE: SABOOR WAIZUN MEDICAL PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center239768NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21891867859OTHERNYNPI

General Provider Information

NPI Number : 1033380902
Entity Type Code : Organization
Provider Name (Legal Business Name) : SABOOR WAIZUN MEDICAL PC
Provider Business Mailing Address
First Line : 8605 SANTIAGO ST
Second Line :
City : HOLLIS
State : NY
Zip : 11423-1117
Country : US
Telephone Number : 646-623-2745
Fax Number : 718-558-0290
Provider Business Practice Location Address
First Line : 486 MCDONALD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-3812
Country : US
Telephone Number : 718-247-7226
Fax Number : 718-558-0290
Authorized Official
Title or Position : MANAGER
Name : TINA MALEK
Credential : MANAGER
Telephone Number : 631-413-4765
Provider Enumeration Date : 03/18/2008
Last Update Date : 06/05/2024

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Directions to “SABOOR WAIZUN MEDICAL PC ” Practice Location

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