Healthcare Provider Details

I. General information

NPI: 1013134683
Provider Name (Legal Business Name): SABINA A MORISSETTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PLANTATION DR
JAFFREY NH
03452-6631
US

IV. Provider business mailing address

2528 CONNECTICUT RIVER RD
SPRINGFIELD VT
05156-9108
US

V. Phone/Fax

Practice location:
  • Phone: 888-481-8704
  • Fax:
Mailing address:
  • Phone: 715-703-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number19079
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number042.0013374
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: