Basic Information
| Provider Information | |||||||||
| NPI: | 1427027275 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SABIR | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | FOSSAN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | FOSSAN | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
| OtherMiddleName: | LYNNE | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 110 W SQUANTUM ST | ||||||||
| Address2: | MANET COMMUNITY HEALTH CENTER | ||||||||
| City: | NO QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021712122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173763000 | ||||||||
| FaxNumber: | 6177741906 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 GEORGE WASHINGTON BLVD | ||||||||
| Address2: | MANET COMMUNITY HEALTH CENTER INC | ||||||||
| City: | HULL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020453069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173763000 | ||||||||
| FaxNumber: | 6177741906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2006 | ||||||||
| LastUpdateDate: | 11/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 226419 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.