Healthcare Provider Details

I. General information

NPI: 1023002664
Provider Name (Legal Business Name): SABATINO CIATTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E GROVE ST
WESTFIELD NJ
07090-1687
US

IV. Provider business mailing address

240 E GROVE ST
WESTFIELD NJ
07090-1687
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-7235
  • Fax: 908-232-1488
Mailing address:
  • Phone: 908-232-7235
  • Fax: 908-232-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA05982800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number25MA05982800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number25MA05982800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: