MEDICARE: REZA SABET MD

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	112262	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09545	OTHER	NY	GHI MEDICARE

General Provider Information

NPI Number	:	1881640191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REZA SABET MD

Provider Business Mailing Address
First Line	:	3 ANDREA COURT
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-5338
Country	:	US
Telephone Number	:	516-864-1230
Fax Number	:	516-908-4644

Provider Business Practice Location Address
First Line	:	175 JERICHO TPKE
Second Line	:	SUITE#204
City	:	SYOSSET
State	:	NY
Zip	:	11791-4532
Country	:	US
Telephone Number	:	516-558-7060
Fax Number	:	516-558-7328

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	10/01/2012

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Directions to “ REZA SABET MD” Practice Location

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