Healthcare Provider Details

I. General information

NPI: 1467252767
Provider Name (Legal Business Name): SABINE DORANCY TEGUM NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BERLIN RD
MARLBOROUGH MA
01752-1176
US

IV. Provider business mailing address

250 BERLIN RD
MARLBOROUGH MA
01752-1176
US

V. Phone/Fax

Practice location:
  • Phone: 857-312-4476
  • Fax:
Mailing address:
  • Phone: 857-312-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2335997
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: