Basic Information
| Provider Information | |||||||||
| NPI: | 1871086835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QADIR | ||||||||
| FirstName: | SABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28 CROSSING DR | ||||||||
| Address2: | |||||||||
| City: | LINWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082211945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094571143 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2112 HARRISBURG PIKE STE 312 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443022 | ||||||||
| FaxNumber: | 7175443021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2018 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MT215214 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | MT215214 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
No ID Information.