Provider Demographics
NPI:1053590117
Name:MASSOOD R BABAI MD INC
Entity type:Organization
Organization Name:MASSOOD R BABAI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASSOOD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BABAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-929-8631
Mailing Address - Street 1:275 GRAHAM RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2203
Mailing Address - Country:US
Mailing Address - Phone:330-929-8631
Mailing Address - Fax:330-929-1686
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:SUITE 8
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2203
Practice Address - Country:US
Practice Address - Phone:330-929-8631
Practice Address - Fax:330-929-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2493663Medicaid
OH2493663Medicaid
OHMA9346961Medicare PIN