Provider Demographics
NPI:1427027275
Name:SABIR, JENNIFER FOSSAN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FOSSAN
Last Name:SABIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:FOSSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15 CORPORATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1966
Mailing Address - Country:US
Mailing Address - Phone:781-826-8065
Mailing Address - Fax:
Practice Address - Street 1:15 CORPORATE PARK DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1966
Practice Address - Country:US
Practice Address - Phone:781-826-8065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H60433Medicare UPIN
A39546Medicare ID - Type Unspecified