Healthcare Provider Details

I. General information

NPI: 1225019482
Provider Name (Legal Business Name): SABRINA LYN BYRNE A.T.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 BERSHIRE RD
SANDY HOOK CT
06482
US

IV. Provider business mailing address

392 STATE ST APT 11F
NORTH HAVEN CT
06473-3172
US

V. Phone/Fax

Practice location:
  • Phone: 845-494-1780
  • Fax:
Mailing address:
  • Phone: 845-494-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: