MEDICARE: DR. MALLORY ELIZABETH SABIN AU.D., CCC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	002476-1	NY

General Provider Information

NPI Number	:	1689913493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALLORY ELIZABETH SABIN AU.D., CCC-A

Provider Business Mailing Address
First Line	:	222 RIDGEVIEW DR
Second Line	:
City	:	EAST ROCHESTER
State	:	NY
Zip	:	14445-1624
Country	:	US
Telephone Number	:	585-406-1392
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 ELMWOOD AVE
Second Line	:	SUITE 400
City	:	ROCHESTER
State	:	NY
Zip	:	14620-3092
Country	:	US
Telephone Number	:	585-271-0680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2013
Last Update Date	:	11/16/2017

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