Provider Demographics
NPI:1790061323
Name:MAHMUD, SARA NAZ (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:NAZ
Last Name:MAHMUD
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-5104
Mailing Address - Country:US
Mailing Address - Phone:646-417-2770
Mailing Address - Fax:
Practice Address - Street 1:171 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-5104
Practice Address - Country:US
Practice Address - Phone:646-417-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407119363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health