Healthcare Provider Details

I. General information

NPI: 1730142613
Provider Name (Legal Business Name): PATRICIA SUSANA SABATINI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3676 PARKER BLVD
PUEBLO CO
81008-2212
US

IV. Provider business mailing address

PO BOX 9000
PUEBLO CO
81008-9000
US

V. Phone/Fax

Practice location:
  • Phone: 719-553-2201
  • Fax: 719-553-2224
Mailing address:
  • Phone: 719-553-2200
  • Fax: 719-553-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37332
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: