Basic Information
| Provider Information | |||||||||
| NPI: | 1396852190 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SABERIN | ||||||||
| FirstName: | MOJDEH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22581 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100872581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104824795 | ||||||||
| FaxNumber: | 8565283117 | ||||||||
| Practice Location | |||||||||
| Address1: | 85 OLD EAGLE SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | STRAFFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190872544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106883744 | ||||||||
| FaxNumber: | 6106884490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD066078L | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0106565000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 181800 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | MD066078L | 01 | PA | MEDICAL LICENSE | OTHER |