Healthcare Provider Details

I. General information

NPI: 1679566483
Provider Name (Legal Business Name): PAULA F SABINO APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WATER ST #2
GUILFORD CT
06437-2877
US

IV. Provider business mailing address

17 WATER ST #2
GUILFORD CT
06437-2877
US

V. Phone/Fax

Practice location:
  • Phone: 203-453-1616
  • Fax: 203-453-1616
Mailing address:
  • Phone: 203-453-1616
  • Fax: 203-453-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number000888
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: