MEDICARE: DR. INAMULHAQUE M SABOOR M.D.

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	207R00000X	Internal Medicine Physician	239768	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1891867859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INAMULHAQUE M SABOOR M.D.

Provider Business Mailing Address
First Line	:	8605 SANTIAGO ST
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-1117
Country	:	US
Telephone Number	:	718-558-0280
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	04/28/2016

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