Provider Demographics
NPI:1053928036
Name:MAHABIR, AMELIA L
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:L
Last Name:MAHABIR
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 1:8866 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7857
Mailing Address - Country:US
Mailing Address - Phone:718-850-0400
Mailing Address - Fax:718-850-4441
Practice Address - Street 1:8866 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7857
Practice Address - Country:US
Practice Address - Phone:718-850-0400
Practice Address - Fax:718-850-4441
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator