Healthcare Provider Details

I. General information

NPI: 1669210928
Provider Name (Legal Business Name): ANGELINA SABETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 S MARYLAND PKWY STE 104
LAS VEGAS NV
89123-4005
US

IV. Provider business mailing address

8860 S MARYLAND PKWY STE 104
LAS VEGAS NV
89123-4005
US

V. Phone/Fax

Practice location:
  • Phone: 702-881-4033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number1669165502
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: