Provider Demographics
NPI:1871086835
Name:QADIR, SABA
Entity type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:QADIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1945
Mailing Address - Country:US
Mailing Address - Phone:609-457-1143
Mailing Address - Fax:
Practice Address - Street 1:2112 HARRISBURG PIKE STE 312
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3022
Practice Address - Fax:717-544-3021
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT215214207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine