Healthcare Provider Details

I. General information

NPI: 1144014515
Provider Name (Legal Business Name): ELENA SABOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 COMMERCE RD
NEWTOWN CT
06470-1607
US

IV. Provider business mailing address

2340 NORTH AVE APT 4C
BRIDGEPORT CT
06604-2317
US

V. Phone/Fax

Practice location:
  • Phone: 475-316-0964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number17842
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: