| Doctor Name: | DR. SANJIDA SHOMA CABOT |
| NPI Number: | 1548522493 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D., PH.D. |
| License Number: | 278027 |
| Business Practice Address: | 34 Commerce Ave Riverhead, NY - 119013118 |
| Business Phone Number: | 6317228880 |
| Business Fax Number: | |
| Mailing Address: | 408 Saddle Cove Rd, BOHEMIA |
| State: | NY |
| Postal Code: | 117162679 |
| Phone Number: | 6315631844 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2012 |
| NPI Last Update Date: | 02/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 278027 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |